Effect of Glucagon-like Peptide-1 Receptor Agonists on Lipid Profiles Among Type 2 Diabetes: A Systematic Review and Network Meta-analysis
Abstract
Purpose The goal of this study was to assess the effect of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on lipid profiles in patients with type 2 diabetes. Methods The MEDLINE, Embase, Cochrane Library, and ClinicalTrials.gov databases were searched from inception through October 31, 2013. Randomized controlled trials with available data were selected if they compared GLP-1 RAs with placebo and traditional antidiabetic drugs with a duration ≥8 weeks. The weighted mean difference for changes in lipid profiles was estimated by using the random effects model, and a network meta-analysis was performed to supplement direct comparisons. Findings Thirty-five trials with 13 treatments were included in the analysis. GLP-1 RAs decreased HDL-C with a range of -0.06 mmol/L (95% CI, -0.11 to -0.01) to -0.13 mmol/L (95% CI, -0.17 to -0.10) compared with thiazolidinediones, whereas thiazolidinediones were associated with a significant increase in HDL-C compared with placebo (0.09 mmol/L [95% CI, 0.06 to 0.12]). A significant reduction in LDL-C was detected for all GLP-1 RAs versus placebo (range, -0.08 to -0.16 mmol/L), insulin (range, -0.10 to -0.19 mmol/L), and thiazolidinediones (range, -0.16 to -0.24 mmol/L). Exenatide, liraglutide 1.8 mg once daily, and taspoglutide decreased total cholesterol with a range of -0.16 mmol/L (95% CI, -0.26 to -0.06) to -0.27 mmol/L (95% CI, -0.41 to -0.12) versus placebo and thiazolidinediones (range, -0.26 to -0.37 mmol/L). The decreased effect was more evident in exenatide long-acting release and liraglutide 1.8 mg once daily. A significant reduction in triglyceride levels was observed with liraglutide 1.8 mg once daily (-0.30 mmol/L [95% CI, -0.49 to -0.11]) and taspoglutide 20 mg once weekly (-0.17 mmol/L [95% CI, -0.31 to -0.01]) versus placebo. Implications GLP-1 RAs were associated with modest reductions in LDL-C, total cholesterol, and triglycerides but no significant improvement in HDL-C. Further evidence is needed to determine if improvements in lipid profiles might translate into reductions in cardiovascular outcomes.
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GLP-1 RAs decrease waist circumference and blood pressure, modify various elements of the lipid profile, and thus result in reduced CVD risk.
“Aside from their previously mentioned benefits, GLP-1 RAs exert several other favorable effects such as the decrease of waist circumference (WC) [60] and blood pressure (BP) [61], as well as the modification of various elements of the lipid profile, thus resulting in reduced CVD risk [62].”
From Sex Differences in Response to Treatment with Glucagon-like Peptide 1 Receptor Agonists: Opportunities for a Tailored Approach to Diabetes and Obesity Care (2022) · cites this paper as [62]
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- Authors
- Sun, F., Wu, S., Wang, J., Guo, S., Chai, S., Yang, Z., Li, L., Zhang, Y., Ji, L., & Zhan, S.
- Affiliations
- Shihezi University (CN)
- Peking University (CN)
- Capital Medical University (CN)
- Corresponding author
- Zhan, Siyan
- ORCID
- Venue
- Clinical Therapeutics
- Publisher
- Elsevier BV
- Published
- 2015-01
- Volume
- 37
- Issue
- 1
- Pages
- 225-241.e8
- ISSN
- 0149-2918 (ISSN-L)
- OpenAlex
- W2072750268
- Cited by
- 232
- References
- 65
- Citations by year
- 2026: 21 · 2025: 25 · 2024: 30 · 2023: 17 · 2022: 21 · 2021: 24 · 2020: 24 · 2019: 17 · 2018: 12 · 2017: 17 · 2016: 19 · 2015: 5
- FWCI
- 2.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust (089276)
- National Natural Science Foundation of China
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- GLP-1 receptor agonists, type 2 diabetes, lipid profile, HDL cholesterol, LDL cholesterol, total cholesterol, triglycerides, exenatide, liraglutide, thiazolidinediones, insulin, cardiovascular risk, dyslipidemia
- MeSH terms
- Liraglutide, Exenatide, Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Insulin, Lipids, Peptides, Venoms, Thiazolidinediones, Incretins
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