Empagliflozin therapy and insulin resistance-associated disorders: effects and promises beyond a diabetic state

Papaetis, Georgios S.

doi:10.5114/amsad.2021.105314

Cited by 12 publications

(7 citation statements)

References 151 publications

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“…[67][68][69][70][71][72][73] In order to enhance the cardiometabolic and hormonal defects associated with this syndrome, the potential combination of GLP-1R agonists/sodium-glucose co-transporter 2 (SGLT2) inhibitors is also being studied. 57,74 Decreased free T levels and FAI have been shown both after LIRA and EXE administration. Significantly increased SHBG concentrations were also reported in numerous studies of LIRA and EXE administration.…”

Section: Discussionmentioning

confidence: 99%

GLP-1 receptor agonists, polycystic ovary syndrome and reproductive dysfunction: Current research and future horizons

Papaetis¹,

Kyriacou²

2022

Adv Clin Exp Med

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Polycystic ovary syndrome (PCOS) is a disorder that involves several organ systems and cellular pathways. It is strongly influenced by environmental and epigenetic factors. The principal goal of all therapeutic approaches to individuals with reproductive abnormalities is the treatment of subfertility or the regulation of menstruation when pregnancy is not desired. Obesity is closely related to insulin resistance (IR) and subsequent hyperinsulinemia, which aggravate hyperandrogenism and impair early follicle development. Weight loss is of vital importance for overweight/obese individuals with anovulatory infertility. The GLP-1R agonists have achieved remarkable weight reduction and abdominal fat loss in patients with type 2 diabetes (T2D), as well as in overweight/obese individuals and individuals with prediabetes. They have also been shown to promote lower fasting insulin levels and insulin resistance markers. These beneficial effects have been suggested to be particularly helpful in women with PCOS, while their possible role in the hypothalamic-pituitary-gonadal axis is under intense research. This review analyzes the current evidence for GLP-1R agonists, focusing on their effects on ovarian morphology, menstrual dysfunction and fertility outcomes. It also discusses their future role in achieving targeted therapeutic approaches.

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Section: Discussionmentioning

confidence: 99%

GLP-1 receptor agonists, polycystic ovary syndrome and reproductive dysfunction: Current research and future horizons

Papaetis¹,

Kyriacou²

2022

Adv Clin Exp Med

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“…Furthermore, the osmotic diuresis induced by SGLT2 inhibitors has been found to promote mainly reduction of the interstitial volume rather than the intravascular volume. This effect can be particularly helpful in the suppression of PIO-induced sodium and fluid retention [ 22 , 176 , 177 ].…”

Section: Discussionmentioning

confidence: 99%

Pioglitazone in diabetic kidney disease: forgotten but not gone

Papaetis¹

2022

Arch Med Sci Atheroscler Dis

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Diabetic kidney disease (DKD) is described in approximately 20–40% of all diabetic patients and is associated with significant cardiovascular and all-cause mortality. The involvement of multiple metabolic, haemodynamic, inflammatory, and tubular pathways in the pathophysiology of DKD generates the need for multitargeted treatment approaches to improve its development at all levels and delay or even reverse its progression. Thiazolidinediones are potent exogenous agonists of PPAR-γ, which augment the effects of insulin on its cellular targets, mainly at the level of adipose tissue. Pioglitazone, currently the main thiazolidinedione in clinical practice, has achieved significant improvements of albuminuria in patients with type 2 diabetes. It can also interfere with most cellular pathways involved in the development and evolution of DKD. This paper explores the pathophysiological mechanisms governing its possible nephroprotective activity during a diabetic state. It also discusses its future role to ameliorate the global burden of DKD.

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“…The activity and financial burden of practicing the administration of LIRA in a daily dose of clinical evidence is also growing that suggests beneficial effects of SGLT2 inhibitors to other IR-related disorders beyond a diabetic state (such as obesity, prediabetes, PCOS, and NAFLD/NASH) [87]. The beneficial effects of this drug class on metabolic outcomes (body weight, BP control) were also reported in a recent meta-analysis of RCTs in non-diabetic individuals [88].…”

Section: Introductionmentioning

confidence: 92%

GLP-1 receptor agonists, SGLT-2 inhibitors, and obstructive sleep apnoea: can new allies face an old enemy?

Papaetis¹

2023

Arch Med Sci Atheroscler Dis

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Obstructive sleep apnoea (OSA) is the most common form of abnormal sleep pattern (ASP). It is characterized by narrowing of the upper airways (complete or partial) during sleep. Although continuous positive airway pressure is recognized as the gold standard treatment of OSA, unfortunately treatment adherence is often suboptimal and does not address the pathophysiological mechanisms governing its pathogenesis. Weight gain is an important risk factor for the development and worsening of OSA both in adults and in children. Meaningful and sustained weight reduction using lifestyle modifications alone remains difficult and challenging. Novel therapeutic strategies are vital because currently there are no approved pharmacological therapies. This paper explores thoroughly both preclinical and clinical studies that investigated the possible role of GLP-1 receptor agonists and SGLT-2 inhibitors in individuals with ASP and especially OSA. It also discusses their future role in order to ameliorate the global burden of OSA.

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Empagliflozin therapy and insulin resistance-associated disorders: effects and promises beyond a diabetic state

Cited by 12 publications

References 151 publications

GLP-1 receptor agonists, polycystic ovary syndrome and reproductive dysfunction: Current research and future horizons

GLP-1 receptor agonists, polycystic ovary syndrome and reproductive dysfunction: Current research and future horizons

Pioglitazone in diabetic kidney disease: forgotten but not gone

GLP-1 receptor agonists, SGLT-2 inhibitors, and obstructive sleep apnoea: can new allies face an old enemy?

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