Effect of Glucagon-like Peptide-1 Receptor Agonists on Lipid Profiles Among Type 2 Diabetes: A Systematic Review and Network Meta-analysis

Sun, Feng; Wu, Shanshan; Wang, Jing; Guo, Shuxia; Chai, Shude; Yang, Zhirong; Li, Lishi; Zhang, Yuan; Ji, Linong; Zhan, Siyan

doi:10.1016/j.clinthera.2014.11.008

Cited by 180 publications

(126 citation statements)

References 44 publications

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“…Several recent meta-analyses indicated modest reductions in fasting LDL-C, total cholesterol, and TG with small or no significant improvement in HDL-C following chronic treatments with GLP-1R agonists (12)(13)(14) or DPP-4 inhibitors (13,15). For example, treatment with exenatide or liraglutide for several weeks to 3 years reduced fasting levels of TG, total cholesterol and LDL-C, increased HDL-C (16)(17)(18)(19); and reduced fasting apoB (19)(20)(21)(22), apoB-48 (a surrogate measure of intestinal lipoprotein particle numbers) (23), and free fatty acid (FFA) (24)(25)(26).…”

Section: Glp-1r Agonists Improve Fasting and Postprandial Lipid Profimentioning

confidence: 99%

Gut Peptides Are Novel Regulators of Intestinal Lipoprotein Secretion: Experimental and Pharmacological Manipulation of Lipoprotein Metabolism

et al. 2015

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Individuals with metabolic syndrome and frank type 2 diabetes are at increased risk of atherosclerotic cardiovascular disease, partially due to the presence of lipid and lipoprotein abnormalities. In these conditions, the liver and intestine overproduce lipoprotein particles, exacerbating the hyperlipidemia of fasting and postprandial states. Incretin-based, antidiabetes therapies (i.e., glucagon-like peptide [GLP]-1 receptor agonists and dipeptidyl peptidase-4 inhibitors) have proven efficacy for the treatment of hyperglycemia. Evidence is accumulating that these agents also improve fasting and postprandial lipemia, the latter more significantly than the former. In contrast, the gut-derived peptide GLP-2, cosecreted from intestinal L cells with GLP-1, has recently been demonstrated to enhance intestinal lipoprotein release. Understanding the roles of these emerging regulators of intestinal lipoprotein secretion may offer new insights into the regulation of intestinal lipoprotein assembly and secretion and provide new opportunities for devising novel strategies to attenuate hyperlipidemia, with the potential for cardiovascular disease reduction.

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Section: Glp-1r Agonists Improve Fasting and Postprandial Lipid Profimentioning

confidence: 99%

Gut Peptides Are Novel Regulators of Intestinal Lipoprotein Secretion: Experimental and Pharmacological Manipulation of Lipoprotein Metabolism

et al. 2015

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“…A significant reduction in triglyceride levels was observed with liraglutide 1.8 mg (-0.30 mmol/L, p<0.0001) versus placebo. 67 Although GLP-1RAs showed improvements in SBP and lipid profile, there was an increase in heart rate of 0.9, 2.1, 2.7 and 2.2 bpm with EBID, once-weekly exenatide, liraglutide and dulaglutide, respectively, when compared with placebo. 66 In head to head comparisons, longer acting GLP-1RAs raised the pulse rate significantly more than short acting ones; 3.6 bpm (p=0.0001) 58 with liraglutide vs lixisenatide and 1.6 bpm (p<0.05) with dulaglutide vs EBID (AWARD 1).…”

Section: Effect On Cardiovascular Risk Factorsmentioning

confidence: 94%

“…However, reduction in diastolic blood pressure failed to reach statistical significance; -0.5 mmHg vs placebo and -0.5 mm Hg vs active control. 66 In addition, a meta-analysis of 35 RCTs showed that GLP-1RAs were associated with modest reductions in total cholesterol, LDL-C, and triglycerides but no significant improvement in HDL-C. 67 Exenatide and liraglutide 1.8 mg decreased total cholesterol by -0.16 to -0.27 mmol/L (p<0.001) versus placebo and TZD. The decrease was more evident with once-weekly exenatide and liraglutide 1.8 mg once daily.…”

Section: Effect On Cardiovascular Risk Factorsmentioning

confidence: 99%

Glucagon like peptide-1 receptor agonist (GLP-1RA) therapy in management of type 2 diabetes: choosing the right agent for individualised care

et al. 2016

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Glucagon like peptide-1 receptor agonists (GLP-1RAs) are a new class of injectable agent used in the management of type 2 diabetes (T2DM). In the UK, NICE approved the use of GLP-1RAs in combination with metformin and sulphonylurea in people with T2DM whose glycaemic control is above target (≥7.5%, 58 mmol/mol) and body mass index (BMI) ≥35 kg/m 2 with other medical problems associated with obesity or for whom insulin therapy would have significant occupational implications or weight loss would benefit other significant obesityrelated comorbidities in people with BMI <35 kg/m 2 . Unlike many other classes of glucose lowering agents, GLP-1RAs not only improve glycaemic control but also promote weight loss with a low risk of hypoglycaemia. In randomised controlled trials, treatment with GLP-1RAs either as monotherapy or in combination with oral hypoglycaemic agents or insulin, has demonstrated significant improvement in glycaemic control by 1-2% with weight loss of approximately 1-5 kg. In addition, they exert a positive effect on cardio-metabolic risk factors by reducing body weight, lowering blood pressure and improving the lipid profile. Gastrointestinal side effects are the most common adverse events with GLP-1RA therapy. Since the first GLP-1RA was approved in 2005, a number of other GLP-1RAs are now available. However, their glycaemic efficacy, safety profiles and mode of delivery differ, and this review article aims to give an overview of differences among GLP-1RAs and to provide decision makers with an overview of the evidence when choosing a particular GLP-1RA for individualised therapy. Br J Diabetes 2016;16:128-137

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“…Improvements in lipid profile by reducing triglycerides, apolipoproteins B-48, free fatty acids, lowdensity lipoprotein cholesterol (LDL-C), and total cholesterol was observed with GLP-1 RA treatment (21). In a meta-analysis of 35 trials, GLP-1 RAs were associated with modest reductions in LDL-C, total cholesterol, and triglycerides but no significant improvement in high density lipoprotein cholesterol (HDL-C) (25). Clinical studies of liraglutide and exenatide also demonstrated significant weight loss, and improvements in CV risk biomarkers like plasminogen activator inhibitor-1 and high-sensitivity C-reactive protein (16,21).…”

Section: Glp-1 Receptor Agonists (Ras)mentioning

confidence: 99%

Cardiovascular benefits of the newer medications for treating type 2 diabetes mellitus

Yandrapalli¹,

Aronow²

2017

J. Thorac. Dis.

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Effect of Glucagon-like Peptide-1 Receptor Agonists on Lipid Profiles Among Type 2 Diabetes: A Systematic Review and Network Meta-analysis

Cited by 180 publications

References 44 publications

Gut Peptides Are Novel Regulators of Intestinal Lipoprotein Secretion: Experimental and Pharmacological Manipulation of Lipoprotein Metabolism

Gut Peptides Are Novel Regulators of Intestinal Lipoprotein Secretion: Experimental and Pharmacological Manipulation of Lipoprotein Metabolism

Glucagon like peptide-1 receptor agonist (GLP-1RA) therapy in management of type 2 diabetes: choosing the right agent for individualised care

Cardiovascular benefits of the newer medications for treating type 2 diabetes mellitus

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