Effect of oral semaglutide on remnant-like lipoprotein cholesterol in patients with ischemic heart disease receiving statin therapy.

IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM

Diabetology International Pub Date : 2025-01-31 eCollection Date: 2025-04-01 DOI:10.1007/s13340-025-00799-w

Shingo Watanabe, Junichi Onuma, Michio Usui

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引用次数: 0

Abstract

Objectives: High remnant-like lipoprotein (RLP) cholesterolemia has been reported as a risk factor for cardiovascular events in stable angina patients receiving statin therapy. However, there are no established treatments for lowering RLP cholesterol in patients on statins. Glucagon-Like Peptide-1 (GLP-1) receptor agonists are known to reduce cardiovascular events, but the underlying mechanism is not fully understood. We hypothesized that the lipid profile-improving effects of GLP-1 receptor agonists may also contribute to lowering RLP cholesterol.The purpose of this study was to investigate whether oral semaglutide, a GLP-1 receptor agonist, exerts a cholesterol-lowering effect on RLP cholesterol.

Methods: This study was designed as a single-center, single-group, before-and-after comparison trial. The study population consisted of patients with ischemic heart disease who were receiving statin therapy, had initiated oral semaglutide for diabetes, and had an RLP cholesterol level of 3.9 mg/dL or higher before starting semaglutide (N = 41). RLP cholesterol levels were measured in all patients 3 months after initiating semaglutide therapy. RLP cholesterol levels before and after semaglutide treatment were compared.

Results: After initiating semaglutide, RLP cholesterol levels were significantly lower compared to baseline levels (before 8.52 ± 3.96 mg/dL After 5.46 ± 2.88 mg/dL, P < 0.001). In 21 patients who switched from DPP-4 inhibitors to semaglutide, RLP cholesterol levels also significantly decreased (7.33 ± 1.03 mg/dL → 6.75 ± 0.95 mg/dL, P < 0.001). Additionally, among 30 patients who were already on SGLT-2 inhibitors, RLP cholesterol levels significantly decreased after starting semaglutide (8.01 ± 3.37 mg/dL → 5.42 ± 2.37 mg/dL, P < 0.001). No correlation was observed between the reduction in RLP cholesterol and weight loss.

Conclusions: Oral semaglutide significantly reduced RLP cholesterol levels in patients with ischemic heart disease who were receiving statin therapy.

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来源期刊

Diabetology International ENDOCRINOLOGY & METABOLISM-

CiteScore

3.90

自引率

4.50%

发文量

期刊介绍： Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.