Król Małgorzata, Kupnicka Patrycja, Żychowska Justyna, Kapczuk Patrycja, Szućko-Kociuba Izabela, Prajwos Eryk, Chlubek Dariusz
Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland.
Institute of Biology, University of Szczecin, 13 Wąska, 71-415 Szczecin, Poland.
Int J Mol Sci. 2025 Jul 15;26(14):6777. doi: 10.3390/ijms26146777.
Cardiovascular diseases (CVDs) are the leading cause of global mortality, with type 2 diabetes mellitus (T2DM) and obesity significantly increasing the risk of CVD. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase-4 inhibitors (DPP-4is) have gained attention for their potential cardioprotective effects. Therefore, this review aims to explore the molecular mechanisms underlying the cardiovascular benefits of these agents. A literature review was conducted searching PubMed databases from 1990 to January 2025, including research on the effects of GLP-1 RA and DPP-4i on cardiovascular health, specifically concerning atherosclerosis, coronary artery disease, vascular health, cardiac arrhythmias, myocardial infarction (MI), and heart failure, with a focus on the biochemical and molecular effects of these drugs. We analyzed 131 scientific publications, which indicate that GLP-1 RA and DPP-4i significantly reduce cardiovascular risk and major adverse cardiovascular events (MACEs), including atherosclerosis, myocardial infarction, and cardiac arrhythmias. These clinical outcomes are attributed to the mitigation of oxidative stress, inflammation, and endothelial dysfunction as well as improvement in mitochondrial function and lipid metabolism. GLP-1 RAs offer substantial cardiovascular benefits, making them valuable in managing T2DM and reducing CVD risk. Their integration into treatment regimens for CVD can reduce hospitalization rates, improve quality of life, and extend life expectancy. DPP-4is, while beneficial, are less effective in cardiovascular protection. Further research is needed to optimize therapeutic strategies and broaden the clinical application of these agents in cardiometabolic care.
心血管疾病（CVDs）是全球死亡的主要原因，2型糖尿病（T2DM）和肥胖显著增加了心血管疾病的风险。胰高血糖素样肽-1受体激动剂（GLP-1 RAs）和二肽基肽酶-4抑制剂（DPP-4is）因其潜在的心脏保护作用而受到关注。因此，本综述旨在探讨这些药物心血管益处背后的分子机制。我们检索了1990年至2025年1月的PubMed数据库进行文献综述，包括关于GLP-1 RA和DPP-4i对心血管健康影响的研究，特别是关于动脉粥样硬化、冠状动脉疾病、血管健康、心律失常、心肌梗死（MI）和心力衰竭，重点关注这些药物的生化和分子效应。我们分析了131篇科学出版物，这些研究表明GLP-1 RA和DPP-4i显著降低心血管风险和主要不良心血管事件（MACEs），包括动脉粥样硬化、心肌梗死和心律失常。这些临床结果归因于氧化应激、炎症和内皮功能障碍的减轻以及线粒体功能和脂质代谢的改善。GLP-1 RAs具有显著的心血管益处，使其在管理T2DM和降低CVD风险方面具有重要价值。将它们纳入CVD治疗方案可以降低住院率、提高生活质量并延长预期寿命。DPP-4is虽然有益，但在心血管保护方面效果较差。需要进一步研究以优化治疗策略并扩大这些药物在心脏代谢护理中的临床应用。
