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
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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.
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