Perspectives of incretin mimetics in cardiovascular diseases
DOI:
https://doi.org/10.12957/bjhbs.2021.59746Keywords:
Incretins, Diabetes type 2, GLP-1, GIP, DPP-4.Abstract
Introduction: Type 2 Diabetes (DM2) is a chronic condition
associated with an increased risk of cardiovascular diseases,
neuropathies, nephropathies and eye diseases. Incretins (GIP
and GLP-1) are hormones important to insulin secretion, and
their actions are compromised in DM2 patients. Objectives:
This review considers the opportunities and challenges of
using incretin mimetics in the treatment of DM2. Methods:
Bibliographic review referring to the period from 2000 to
2020, in electronic databases such as Scielo, Lilacs, PubMed,
Web of Science. Results: Incretins stimulate insulin secretion
by the pancreas in response to nutrient intake, with a lower
potential to cause hypoglycemia. In addition, they have a
cardioprotective role, reducing blood pressure, improving
endothelial and myocardial function, and their use has been
associated with a reduction in the risk of cardiovascular
events, including cardiovascular mortality. Clinical trials
with GLP-1R agonists (GLP-1RA) reduced albuminuria, increased
natriuresis, and decreased oxidative stress. In addition,
treatment with incretin mimetics reduced the occurrence of
the main cardiovascular outcomes related to atherosclerosis,
promoted weight loss and improved lipid profile. Conclusion:
Studies show the important role of incretin mimetics in the
pathophysiology and treatment of DM2, with significant
effects in the cardiovascular system. However, its use must be
evaluated in relation to its safety and to in which individuals
the benefits outweigh the risks associated with the treatment.
Thus, its clinical relevance depends on studies with long-term
follow-up of patients, with analysis of its impact on mortality
and on the development of micro and macrovascular
complications.
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