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Effects of 6-month treatment with the glucagon like peptide-1 analogue liraglutide on arterial stiffness, left ventricular myocardial deformation and oxidative stress in subjects with newly diagnosed type 2 diabetes
Open accessAbstract
Abstract Background Incretin-based therapies are used in the treatment of type 2 diabetes mellitus (T2DM) and obesity. We investigated the changes in arterial stiffness and left ventricular (LV) myocardial deformation after 6-month treatment with the GLP-1 analogue liraglutide in subjects with newly diagnosed T2DM. Methods We randomized 60 patients with newly diagnosed and treatment-naive T2DM to receive either liraglutide (n = 30) or metformin (n = 30) for 6 months. We measured at baseline and after 6-month treatment: (a) carotid-femoral pulse wave velocity (PWV) (b) LV longitudinal strain (GLS), and strain rate (GLSR), peak twisting (pTw), peak twisting velocity (pTwVel) and peak untwisting velocity (pUtwVel) using speckle tracking echocardiography. LV untwisting was calculated as the percentage difference between peak twisting and untwisting at MVO (%dpTw–UtwMVO), at peak (%dpTw–UtwPEF) and end of early LV diastolic filling (%dpTw–UtwEDF) (c) Flow mediated dilatation (FMD) of the brachial artery and percentage difference of FMD (FMD%) (d) malondialdehyde (MDA), protein carbonyls (PCs) and NT-proBNP. Results After 6-months treatment, subjects that received liraglutide presented with a reduced PWV (11.8 ± 2.5 vs. 10.3 ± 3.3 m/s), MDA (0.92 [0.45–2.45] vs. 0.68 [0.43–2.08] nM/L) and NT-proBNP (p < 0.05) in parallel with an increase in GLS (− 15.4 ± 3 vs. − 16.6 ± 2.7), GLSR (0.77 ± 0.2 vs. 0.89 ± 0.2), pUtwVel (− 97 ± 49 vs. − 112 ± 52°, p < 0.05), %dpTw–UtwMVO (31 ± 10 vs. 40 ± 14), %dpTw–UtwPEF (43 ± 19 vs. 53 ± 22) and FMD% (8.9 ± 3 vs. 13.2 ± 6, p < 0.01). There were no statistically significant differences of the measured markers in subjects that received metformin except for an improvement in FMD. In all subjects, PCs levels at baseline were negatively related to the difference of GLS (r = − 0.53) post-treatment and the difference of MDA was associated with the difference of PWV (r = 0.52) (p < 0.05 for all associations) after 6-month treatment. Conclusions Six-month treatment with liraglutide improves arterial stiffness, LV myocardial strain, LV twisting and untwisting and NT-proBNP by reducing oxidative stress in subjects with newly diagnosed T2DM. ClinicalTrials.gov Identifier NCT03010683
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“Similarly, evidence for oxidative stress markers like MDA is promising but varied, with some trials showing clear superiority of GLP-1 RAs over insulin or metformin (9, 21, 22).”
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“In mechanistic studies, GLP-1RAs were shown to improve cardiac function in patients with T2DM.”
From The cardioprotective effects of semaglutide exceed those of dietary weight loss in mice with HFpEF (2023) · cites this paper as [46]
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Metadata
- Authors
- Lambadiari, V., Pavlidis, G., Kousathana, F., Varoudi, M., Vlastos, D., Maratou, E., Georgiou, D., Andreadou, I., Parissis, J., Triantafyllidi, H., Lekakis, J., Iliodromitis, E., Dimitriadis, G., & Ikonomidis, I.
- Affiliations
- National and Kapodistrian University of Athens (GR)
- Corresponding author
- Lambadiari, Vaia
- ORCID
- Venue
- Cardiovascular Diabetology
- Published
- 2018-01-08
- Volume
- 17
- Issue
- 1
- Pages
- 8-8
- ISSN
- 1475-2840 (ISSN-L)
- PMC
- PMC5759220
- OpenAlex
- W2782989965
- Cited by
- 146
- References
- 52
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 18 · 2023: 16 · 2022: 17 · 2021: 22 · 2020: 21 · 2019: 22 · 2018: 7
- FWCI
- 14.31
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Cardiovascular Diabetology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- liraglutide, GLP-1 receptor agonists, type 2 diabetes, newly diagnosed diabetes, arterial stiffness, left ventricular myocardial deformation, oxidative stress, metformin, pulse wave velocity, flow-mediated dilation, malondialdehyde, protein carbonyls, NT-proBNP, speckle tracking echocardiography
- MeSH terms
- Glucagon-Like Peptide-1 Receptor, Liraglutide, Glucagon-Like Peptide-1 Receptor Agonists, Adult, Biomechanical Phenomena, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Female, Greece, Humans, Hypoglycemic Agents, Male, Middle Aged, Myocardial Contraction, Peptide Fragments, Time Factors, Biomarkers, Ventricular Function, Left, Treatment Outcome, Oxidative Stress, Natriuretic Peptide, Brain, Incretins, Diabetic Cardiomyopathies, Vascular Stiffness
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