Seksaria Sanket, Dutta Bhaskar Jyoti, Kaur Mandeep, Gupta Ghanshyam Das, Bodakhe Surendra H, Singh Amrita
Department of Pharmacology, ISF College of Pharmacy, GT Road, GhalKalan, Moga 142001, Punjab, India.
Department of Pharmacy, Sanaka Educational Trust's Group of Institutions, Malandighi, Durgapur 713212, India.
Curr Diabetes Rev. 2024;20(6):e090823219597. doi: 10.2174/1573399820666230809152148.
Cardiovascular complications and renal disease is the growing cause of mortality in patients with diabetes. The subversive complications of diabetes such as hyperglycemia, hyperlipidemia and insulin resistance lead to an increase in the risk of myocardial infarction (MI), stroke, heart failure (HF) as well as chronic kidney disease (CKD). Among the commercially available anti-hyperglycemic agents, incretin-based medications appear to be safe and effective in the treatment of type 2 diabetes mellitus (T2DM) and associated cardiovascular and renal disease. Glucagon-like peptide 1 receptor agonists (GLP-1RAs) have been shown to be fruitful in reducing HbA1c, blood glucose, lipid profile, and body weight in diabetic patients. Several preclinical and clinical studies revealed the safety, efficacy, and preventive advantages of GLP-1RAs against diabetes- induced cardiovascular and kidney disease. Data from cardio-renal outcome trials had highlighted that GLP-1RAs protected people with established CKD from significant cardiovascular disease, lowered the likelihood of hospitalization for heart failure (HHF), and lowered all-cause mortality. They also had a positive effect on people with end-stage renal disease (ESRD) and CKD. Beside clinical outcomes, GLP-1RAs reduced oxidative stress, inflammation, fibrosis, and improved lipid profile pre-clinically in diabetic models of cardiomyopathy and nephropathy that demonstrated the cardio-protective and reno-protective effect of GLP-1RAs. In this review, we have focused on the recent clinical and preclinical outcomes of GLP-1RAs as cardio-protective and reno-protective agents as GLP-1RAs medications have been demonstrated to be more effective in treating T2DM and diabetes-induced cardiovascular and renal disease than currently available treatments in clinics, without inducing hypoglycemia or weight gain.
心血管并发症和肾脏疾病是糖尿病患者死亡人数不断增加的原因。糖尿病的颠覆性并发症，如高血糖、高血脂和胰岛素抵抗，会增加心肌梗死（MI）、中风、心力衰竭（HF）以及慢性肾病（CKD）的风险。在市售的抗高血糖药物中，基于肠促胰素的药物在治疗2型糖尿病（T2DM）及其相关心血管和肾脏疾病方面似乎是安全有效的。胰高血糖素样肽1受体激动剂（GLP-1RAs）已被证明在降低糖尿病患者的糖化血红蛋白、血糖、血脂水平和体重方面卓有成效。多项临床前和临床研究揭示了GLP-1RAs在预防糖尿病引起的心血管和肾脏疾病方面的安全性、有效性和优势。心血管肾脏结局试验的数据突出表明，GLP-1RAs可保护已患CKD的患者免受重大心血管疾病的侵害，降低因心力衰竭住院（HHF）的可能性，并降低全因死亡率。它们对终末期肾病（ESRD）和CKD患者也有积极作用。除了临床结局，在糖尿病性心肌病和肾病模型中，GLP-1RAs在临床前可降低氧化应激、炎症、纤维化，并改善血脂水平，这证明了GLP-1RAs的心脏保护和肾脏保护作用。在本综述中，我们重点关注了GLP-1RAs作为心脏保护和肾脏保护药物的近期临床和临床前结局，因为已证明GLP-1RAs药物在治疗T2DM以及糖尿病引起的心血管和肾脏疾病方面比目前临床上可用的治疗方法更有效，且不会引起低血糖或体重增加。
