PDF(Pubmed)
Abstract：
Background and Objectives: The rise in global diabetes cases, reaching a staggering 529 million in 2021 from 108 million in 1980, underscores the urgency of addressing its complications, notably macrovascular ones like coronary artery, cerebrovascular, and peripheral artery diseases, which contribute to over 50% of diabetes mortality. Atherosclerosis, linked to hyperglycemia-induced endothelial dysfunction, is pivotal in cardiovascular disease development. Cytokines, including pentraxin 3 (PTX3), copeptin, lipoprotein(a) [Lp(a)], and matrix metalloproteinase-9 (MMP-9), influence atherosclerosis progression and plaque vulnerability. Inhibiting atherosclerosis progression is crucial, especially in diabetic individuals. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs), increasingly used for type 2 diabetes, show promise in reducing the cardiovascular risk, sparking interest in their effects on atherogenesis. This study sought to examine the effects of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on biomarkers that indicate the instability of atherosclerotic plaques. These biomarkers include pentraxin 3 (PTX3), copeptin (CPC), matrix metalloproteinase-9 (MMP-9), and lipoprotein(a) [Lp(a)]. Materials and Methods: A total of 34 participants, ranging in age from 41 to 81 years (with an average age of 61), who had been diagnosed with type 2 diabetes mellitus (with a median HbA1c level of 8.8%), dyslipidemia, and verified atherosclerosis using B-mode ultrasonography, were included in the study. All subjects were eligible to initiate treatment with a GLP-1 RA-dulaglutide. Results: Significant reductions in anthropometric parameters, blood pressure, fasting glucose levels, and HbA1c levels were observed posttreatment. Moreover, a notable decrease in biochemical markers associated with atherosclerotic plaque instability, particularly PTX3 and MMP-9 (p < 0.001), as well as Lp(a) (p < 0.05), was evident following the GLP-1 RA intervention. Conclusions: These findings underscore the potential of GLP-1 RAs in mitigating atherosclerosis progression and plaque vulnerability, thus enhancing cardiovascular outcomes in individuals with type 2 diabetes mellitus.
摘要：
背景和目的：全球糖尿病病例的增加，从1980年的1.08亿，到2021年达到惊人的5.29亿，突显了解决其并发症的紧迫性，特别是大血管血管，如冠状动脉，脑血管,和外周动脉疾病，这导致了50%以上的糖尿病死亡率。动脉粥样硬化,与高血糖诱导的内皮功能障碍有关，是心血管疾病发展的关键。细胞因子,包括pentraxin3（PTX3），copeptin,脂蛋白（a）[Lp（a）]，和基质金属蛋白酶-9（MMP-9），影响动脉粥样硬化进展和斑块易损性。抑制动脉粥样硬化进展至关重要，尤其是糖尿病患者。胰高血糖素样肽1受体激动剂（GLP-1RAs），越来越多地用于2型糖尿病，显示出降低心血管风险的希望，引起人们对它们对动脉粥样硬化的影响的兴趣。这项研究试图检查胰高血糖素样肽-1受体激动剂（GLP-1RA）对生物标志物的影响，这些生物标志物表明动脉粥样硬化斑块的不稳定性。这些生物标志物包括pentraxin3（PTX3），copeptin（CPC），基质金属蛋白酶-9(MMP-9),和脂蛋白(a)[Lp(a)]。材料与方法：共有34名参与者，年龄从41岁到81岁（平均年龄为61岁），被诊断为2型糖尿病（HbA1c中位数为8.8％），血脂异常,用B超证实动脉粥样硬化，包括在研究中。所有受试者都有资格开始用GLP-1RA-杜拉鲁肽治疗。结果：人体测量参数显着降低，血压,空腹血糖水平,治疗后观察HbA1c水平。此外，与动脉粥样硬化斑块不稳定相关的生化指标显着下降，特别是PTX3和MMP-9（p<0.001），以及Lp(a)(p<0.05)，在GLP-1RA干预后很明显。结论：这些发现强调了GLP-1RA在缓解动脉粥样硬化进展和斑块易损性方面的潜力。从而增强2型糖尿病患者的心血管结局。
