Liraglutide Decreases Carotid IMT in Patients With T2DM
Liraglutide Decreases Carotid IMT in Patients With T2DM
Background: Liraglutide, a long-acting glucagon-like peptide-1 (GLP-1) analog, has several non- glycemic properties, but its effect on carotid intima-media thickness (IMT), a recognized marker of subclinical atherosclerosis, is still unknown.
Methods: A prospective study of 8 months duration in 64 patients with type-2 diabetes and no prior history of coronary artery disease evaluated whether adding liraglutide to metformin affects carotid IMT, measured by color doppler ultrasound.
Results: After 8 months, fasting glucose decreased by 2.1 mmol/l and HbA1c by 1.9% (p < 0.01 for all). Liraglutide reduced total-cholesterol and triglycerides by 10%, and LDL-cholesterol by 19%, whereas HDL-cholesterol increased by 18% (p < 0.01 for all lipid changes). Carotid IMT decreased from 1.19 ± 0.47 to 0.94 ± 0.21 mm (p < 0.01). Yet, changes in carotid IMT did not correlate with changes in any other variable studied.
Conclusions: Liraglutide decreases carotid IMT after 8 months treatment independently of its effect on plasma glucose and lipids concentrations.
Liraglutide is a long-acting human glucagon-like peptide-1 (GLP-1) analog suitable for once-daily administration in patients with type-2 diabetes (T2DM). Clinical studies have demonstrated glucose-reducing effects, improvements in pancreatic beta cell function and a low risk of hypoglycaemic events with this agent. Liraglutide has also shown favorable effects on inflammatory markers, such as C-reactive protein (CRP), tumour necrosis factor-α (TNF-α) and plasminogen activator inhibitor type-1 (PAI-1). Further, liraglutide seems to also have an impact on diabetic dyslipidemia, reducing total cholesterol, triglycerides and low density lipoproteins (LDL)-cholesterol levels, with a concomitant increase in high density lipoproteins (HDL)-cholesterol.
These favorable effects of liraglutide on multiple metabolic pathways may have beneficial effects on atherosclerosis and possibly reduce risk for cardiovascular disease. However, prospective studies to elucidate the clinical impact of liraglutide on cardiovascular outcomes in patients with T2DM, such as the international LEADER (Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results) study, are still ongoing. We performed a pilot study to explore, for the first time, the effects of liraglutide on carotid intima-media thickness (IMT), a recognized marker of subclinical atherosclerosis, thus providing a preliminary view on the potential impact of this therapeutic intervention on cardiovascular risk of patients with T2DM.
Abstract and Introduction
Abstract
Background: Liraglutide, a long-acting glucagon-like peptide-1 (GLP-1) analog, has several non- glycemic properties, but its effect on carotid intima-media thickness (IMT), a recognized marker of subclinical atherosclerosis, is still unknown.
Methods: A prospective study of 8 months duration in 64 patients with type-2 diabetes and no prior history of coronary artery disease evaluated whether adding liraglutide to metformin affects carotid IMT, measured by color doppler ultrasound.
Results: After 8 months, fasting glucose decreased by 2.1 mmol/l and HbA1c by 1.9% (p < 0.01 for all). Liraglutide reduced total-cholesterol and triglycerides by 10%, and LDL-cholesterol by 19%, whereas HDL-cholesterol increased by 18% (p < 0.01 for all lipid changes). Carotid IMT decreased from 1.19 ± 0.47 to 0.94 ± 0.21 mm (p < 0.01). Yet, changes in carotid IMT did not correlate with changes in any other variable studied.
Conclusions: Liraglutide decreases carotid IMT after 8 months treatment independently of its effect on plasma glucose and lipids concentrations.
Introduction
Liraglutide is a long-acting human glucagon-like peptide-1 (GLP-1) analog suitable for once-daily administration in patients with type-2 diabetes (T2DM). Clinical studies have demonstrated glucose-reducing effects, improvements in pancreatic beta cell function and a low risk of hypoglycaemic events with this agent. Liraglutide has also shown favorable effects on inflammatory markers, such as C-reactive protein (CRP), tumour necrosis factor-α (TNF-α) and plasminogen activator inhibitor type-1 (PAI-1). Further, liraglutide seems to also have an impact on diabetic dyslipidemia, reducing total cholesterol, triglycerides and low density lipoproteins (LDL)-cholesterol levels, with a concomitant increase in high density lipoproteins (HDL)-cholesterol.
These favorable effects of liraglutide on multiple metabolic pathways may have beneficial effects on atherosclerosis and possibly reduce risk for cardiovascular disease. However, prospective studies to elucidate the clinical impact of liraglutide on cardiovascular outcomes in patients with T2DM, such as the international LEADER (Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results) study, are still ongoing. We performed a pilot study to explore, for the first time, the effects of liraglutide on carotid intima-media thickness (IMT), a recognized marker of subclinical atherosclerosis, thus providing a preliminary view on the potential impact of this therapeutic intervention on cardiovascular risk of patients with T2DM.
