Lipid profile changes induced by glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes: a systematic review and network meta-analysis.

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Expert Review of Clinical Pharmacology Pub Date : 2024-08-01 Epub Date: 2024-06-06 DOI:10.1080/17512433.2024.2363838

Yuna Chae, Sun-Hong Kwon, Jin Hyun Nam, Eunsung Kang, Jiae Im, Hyo-Jin Kim, Eui-Kyung Lee

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Abstract

Objective: This study was conducted to investigate the effects of glucagon-like peptide-1 receptor (GLP-1) agonists on the lipid profiles of patients with type 2 diabetes.

Methods: We retrieved the data of phase 3 randomized controlled trials on GLP-1 agonists in patients with type 2 diabetes from the PubMed, Embase, and Cochrane library up to 11 February 2024. We extracted % changes in low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol/total cholesterol (T-CHO) and triglycerides levels from baseline. Using Bayesian network meta-analysis, mean differences and 95% credible intervals for lipid changes were estimated as a unit of percentage points (%p) by class.

Results: Twenty-six studies covering 22,290 participants were included. The glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 dual agonist showed significant differences in LDL-C (range of mean differences: -11.61 to -6.77%p), triglycerides (-19.94 to -13.31%p), and T-CHO (-7.94 to -5.09%p) levels compared to placebo, insulin, and sodium-glucose co-transporter 2 (SGLT2) inhibitors. The GLP-1 agonist significantly reduced T-CHO (-5.20%p; -6.39%p) and LDL-C (-4.32%p; -8.17%p) levels compared to placebo and SGLT2 inhibitors, respectively.

Conclusions: The GIP/GLP-1 dual agonist positively affects the lipid profiles of patients with type 2 diabetes. This may contribute to a lower risk of cardiovascular disease in patients with type 2 diabetes.

Protocol registration: PROSPERO (CRD42021282668).

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胰高血糖素样肽-1 受体激动剂诱导的 2 型糖尿病患者血脂变化：系统综述和网络荟萃分析。

研究目的本研究旨在探讨胰高血糖素样肽-1受体（GLP-1）激动剂对2型糖尿病患者血脂状况的影响：我们从 PubMed、Embase 和 Cochrane 图书馆检索了截至 2024 年 2 月 11 日有关 GLP-1 激动剂治疗 2 型糖尿病患者的 3 期随机对照试验数据。我们提取了低密度脂蛋白胆固醇（LDL-C）/高密度脂蛋白胆固醇/总胆固醇（T-CHO）和甘油三酯水平与基线相比的变化百分比。采用贝叶斯网络荟萃分析法，以百分点（%p）为单位，按等级估算血脂变化的平均差异和 95% 可信区间：共纳入 26 项研究，覆盖 22,290 名参与者。与安慰剂、胰岛素和钠-葡萄糖协同转运体 2（SGLT2）抑制剂相比，葡萄糖依赖性胰岛素多肽（GIP）/GLP-1 双激动剂在低密度脂蛋白胆固醇（-11.61% 至 -6.77%p）、甘油三酯（-19.94% 至 -13.31%p）和 T-CHO （-7.94% 至 -5.09%p）水平上有显著差异。与安慰剂和SGLT2抑制剂相比，GLP1激动剂能显著降低T-CHO（-5.20%p；-6.39%p）和LDL-C（-4.32%p；-8.17%p）水平：GIP/GLP-1双重激动剂对2型糖尿病患者的血脂状况有积极影响。结论：GIP/GLP-1 双激动剂对 2 型糖尿病患者的血脂状况有积极影响，这可能会降低罹患心血管疾病的风险：prospero（CRD42021282668）。

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来源期刊

Expert Review of Clinical Pharmacology PHARMACOLOGY & PHARMACY-

CiteScore

7.30

自引率

2.30%

发文量

127

期刊介绍： Advances in drug development technologies are yielding innovative new therapies, from potentially lifesaving medicines to lifestyle products. In recent years, however, the cost of developing new drugs has soared, and concerns over drug resistance and pharmacoeconomics have come to the fore. Adverse reactions experienced at the clinical trial level serve as a constant reminder of the importance of rigorous safety and toxicity testing. Furthermore the advent of pharmacogenomics and ‘individualized’ approaches to therapy will demand a fresh approach to drug evaluation and healthcare delivery. Clinical Pharmacology provides an essential role in integrating the expertise of all of the specialists and players who are active in meeting such challenges in modern biomedical practice.