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

• Published in: Cardiovascular diabetology Vol. 17; no. 1; pp. 8 - 12
• Main Authors: Lambadiari, Vaia, Pavlidis, George, Kousathana, Foteini, Varoudi, Maria, Vlastos, Dimitrios, Maratou, Eirini, Georgiou, Dimitrios, Andreadou, Ioanna, Parissis, John, Triantafyllidi, Helen, Lekakis, John, Iliodromitis, Efstathios, Dimitriadis, George, Ikonomidis, Ignatios
• Format: Journal Article
• Language: English
• Published: London BioMed Central 08.01.2018; BMC
• Subjects: Adult; Angiology; Arterial stiffness; Augmentation index; Biomarkers - blood; Biomechanical Phenomena; Cardiology; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - physiopathology; Diabetic Angiopathies - blood; Diabetic Angiopathies - drug therapy; Diabetic Angiopathies - etiology; Diabetic Angiopathies - physiopathology; Diabetic Cardiomyopathies - blood; Diabetic Cardiomyopathies - drug therapy; Diabetic Cardiomyopathies - etiology; Diabetic Cardiomyopathies - physiopathology; Female; Glp-1 analogue; Glucagon-Like Peptide-1 Receptor - agonists; Glucagon-Like Peptide-1 Receptor - metabolism; Greece; Humans; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Incretins - adverse effects; Incretins - therapeutic use; Left ventricular function; Liraglutide; Liraglutide - adverse effects; Liraglutide - therapeutic use; Male; Medicine; Medicine & Public Health; Metformin; Middle Aged; Myocardial Contraction - drug effects; Natriuretic Peptide, Brain - blood; Original Investigation; Oxidative Stress - drug effects; Peptide Fragments - blood; Time Factors; Treatment Outcome; Vascular Stiffness - drug effects; Ventricular Function, Left - drug effects; Greece; Oxidative stress; Arterial stiffness; Augmentation index; Metformin; Glp-1 analogue; Liraglutide; Left ventricular function
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/s12933-017-0646-z

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–Utw MVO ), at peak (%dpTw–Utw PEF ) and end of early LV diastolic filling (%dpTw–Utw EDF ) (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–Utw MVO (31 ± 10 vs. 40 ± 14), %dpTw–Utw PEF (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