Title:Glucagon Like Peptide-1 and Atherosclerosis
Volume: 10
Issue: 4
Author(s): Tomoya Mita and Hirotaka Watada
Affiliation:
Keywords:
Atherosclerosis, diabetes, endothelial cells, glucagon-like peptide-1, macrophage/monocyte, smooth muscle cells
Abstract: Patients with type 2 diabetes mellitus are at high risk for developing cardiovascular diseases. Traditional
medicines for type 2 diabetes, such as sulfonylureas, pioglitazone, and insulin have glucose lowering effects; however,
they also increase the frequency of hypoglycemia and/or body weight and thus may cancel out the benefits of glucose
lowering on the development of atherosclerosis. In contrast, the recently developed glucagon like peptide-1-based therapy
using glucagon-like peptide-1 receptor agonists or dipeptidyl peptidase-4 inhibitors has numerous beneficial effects in the
management of hyperglycemia with less risk of hypoglycemia and weight gain. Glucagon-like peptide-1-based therapy
also lowers blood pressure and blood lipids and thus may prevent progression of atherosclerosis. Furthermore, glucagonlike
peptide-1 receptors are abundantly expressed in vascular cells such as endothelial cells, monocyte/macrophages and
smooth muscle cells. Recent studies suggest that the anti-inflammatory and vasodilatory properties of glucagon-like
peptide-1 signaling on endothelial cells, its anti-inflammatory effect on macrophages and anti-proliferative effects on
smooth muscle cells may halt atherosclerosis. Although large clinical trials are required to confirm these beneficial
effects, glucagon-like peptide-1-based therapy could provide both glucose lowering and protection against cardiovascular
diseases in patients with type 2 diabetes.
