CO01 | Cardiovascular and metabolic effects of GLP-1RAs in patients with type 2 diabetes mellitus: a preliminary longitudinal study

A. Al Refaie¹, L. Baldassini², C. Mondillo², E. Ceccarelli², R. Tarquini³, L. Gennari², S. Gonnelli², C. Caffarelli² | ¹Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena; Division of Internal Medicine I, San Giuseppe Hospital, Empoli, ²Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, ³Division of Internal Medicine I, San Giuseppe Hospital, Empoli, Italy

Abstract

Aim: Type 2 diabetes mellitus (T2DM) is the most common metabolic disorder in the world. T2DM involves numerous cardiovascular complications, which are a cause of morbidity, mortality and increased public spending worldwide. The real challenge of new diabetes drugs is to prevent cardiovascular risk. The new receptor agonists for glucagon-like peptide-1 (GLP-1RAs) have been shown to play a key role in cardiovascular risk too.
Methods: We carried out a longitudinal study of 12 months evaluating the cardio-metabolic effects of GLP-1RAs on a cohort of 80 Caucasian patients with T2DM referred to the Department of Internal Medicine at the University Hospital of Siena, Italy.
Results: GLP-1RAs led to several positive changes in our study population, in addition to a weight loss we observed: a change in fat distribution with reduction in the percentage of visceral fat (1.21 vs. 1.17, p<0.05); a significant reduction in the levels of LDL cholesterol (p<0.05) and triglycerides.(p<0.01); an increase in the values of adiponectin which could reflect a reduction in insulin resistance and in inflammatory state. We also observed a reduction in microalbuminuria and in media-intimal thickness at the epiaortic vessels (p=0.05).
Conclusions: In patients with T2DM 1-year therapy with GLP-1RAs has a positive effect on the main determinants of cardiovascular risk including body weight, visceral fat, dyslipidemia and atherosclerosis. Moreover, the increase in adiponectin may play a pivotal role in controlling the inflammatory state and the mechanisms of vascular damage.