口服西马鲁肽对接受他汀类药物治疗的缺血性心脏病患者残余样脂蛋白胆固醇的影响。

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

摘要

目的：高残余样脂蛋白（RLP）胆固醇血症已被报道为接受他汀类药物治疗的稳定型心绞痛患者心血管事件的危险因素。然而，对于服用他汀类药物的患者，目前尚无降低RLP胆固醇的既定治疗方法。已知胰高血糖素样肽-1 （GLP-1）受体激动剂可减少心血管事件，但其潜在机制尚不完全清楚。我们假设GLP-1受体激动剂改善脂质谱的作用也可能有助于降低RLP胆固醇。本研究的目的是探讨口服semaglutide（一种GLP-1受体激动剂）是否对RLP胆固醇具有降胆固醇作用。方法：本研究设计为单中心、单组、前后比较试验。研究人群包括正在接受他汀类药物治疗的缺血性心脏病患者，已经开始口服西马鲁肽治疗糖尿病，并且在开始使用西马鲁肽之前RLP胆固醇水平为3.9 mg/dL或更高（N = 41）。在开始西马鲁肽治疗3个月后测量所有患者的RLP胆固醇水平。比较西马鲁肽治疗前后RLP胆固醇水平。结果：开始使用西马鲁肽后，RLP胆固醇水平与基线水平相比显著降低（8.52±3.96 mg/dL前，5.46±2.88 mg/dL后，P P P P）结论：口服西马鲁肽可显著降低接受他汀类药物治疗的缺血性心脏病患者RLP胆固醇水平。

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

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.