Liraglutide Reduces Carotid Intima-Media Thickness by Reducing Small Dense Low-Density Lipoproteins in a Real-World Sett
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ORIGINAL RESEARCH
Liraglutide Reduces Carotid Intima-Media Thickness by Reducing Small Dense Low-Density Lipoproteins in a Real-World Setting of Patients with Type 2 Diabetes: A Novel Anti-Atherogenic Effect Dragana Nikolic
. Rosaria Vincenza Giglio . Ali A. Rizvi .
Angelo Maria Patti . Giuseppe Montalto . Francesco Maranta . Domenico Cianflone . Anca Pantea Stoian . Manfredi Rizzo Received: September 30, 2020 / Accepted: October 27, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: Liraglutide has several non-glycemic effects, including those on plasma lipids and lipoproteins, contributing to its cardiovascular benefit; however, the exact underlying mechanisms remain unclear. We investigated a D. Nikolic (&) R. V. Giglio A. M. Patti G. Montalto M. Rizzo Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy e-mail: [email protected]; [email protected] D. Nikolic R. V. Giglio A. M. Patti Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo, Italy A. A. Rizvi Division of Endocrinology, Metabolism, and Lipids, Emory University School of Medicine, Atlanta, GA, USA A. A. Rizvi M. Rizzo Department of Medicine, School of Medicine, University of South Carolina, Columbia, SC, USA F. Maranta D. Cianflone Cardiovascular Rehabilitation, San Raffaele Scientific Institute and San Raffaele Vita-Salute University, Milan, Italy A. P. Stoian Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
novel anti-atherogenic effect of liraglutide in a real-world prospective study on patients with type 2 diabetes (T2DM). Methods: Sixty-two patients with T2DM (31 men, 31 women; mean age ± standard deviation 61 ± 9 years) naı¨ve to incretin-based therapies were treated with liraglutide (1.2 mg/day) as add-on therapy to metformin (1500– 3000 mg/day) for 4 months. Laboratory analyses included the assessment of lipoprotein subclass profile by gel electrophoresis (Lipoprint; Quantimetrix Corp., Redondo Beach, CA, USA). Carotid intima-media thickness (cIMT) was assessed by Doppler ultrasonography. Statistical analyses included the paired t test, Spearman correlation and multiple regression analysis. Results: The addition of liraglutide to metformin monotherapy resulted in significant reductions in fasting glycemia, hemoglobin A1c, body mass index, waist circumference, total cholesterol, triglycerides and low-density lipoprotein (LDL)-cholesterol, as well as in cIMT. There was an increase in the large LDL-1 subfraction, with a concomitant reduction in atherogenic small dense LDL-3 and LDL-4 subfractions. Correlation analysis revealed a significant association between changes in cIMT and changes in small dense LDL-3 subfraction (r = 0.501; p \ 0.0001). Multivariate analysis, including all of the measured anthropometric and laboratory parameters, revealed that only changes in the small dense LDL-3 subfraction
Diabetes
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