Impact of glucagon-like peptide-1 on myocardial glucose metabolism revisited

Jan Hansen, Birgitte Brock, Hans Erik Bøtker, Albert Gjedde, Jørgen Rungby, Michael Gejl

Research output: Contribution to journalArticle

Abstract

The gut hormone glucagon-like peptide-1 (GLP-1) is an insulinotropic incretin with significant cardiovascular impact. Two classes of medication, GLP-1 analogues and DPP-4 inhibitors, have been developed that circumvent the rapid degradation of GLP-1 by the enzyme dipeptidyl peptidase-4 (DPP-4), both enhance the incretin effect and were developed for the treatment of type 2 diabetes. Several mechanisms suggesting that DPP-4 inhibitors, GLP-1, and analogues could have a protective effect on the cardiovascular risk profile have been forwarded; e.g., reductions of blood glucose, body weight, blood pressure, improvement in left ventricular ejection fraction, myocardial perfusion, atherosclerosis development, and endothelial function. Despite this, the reasons for a decreased risk of developing cardiovascular disease and reduced post-ischaemia damage are still poorly understood. The potentially beneficial effect of GLP-1 stimulation may rely on, among others, improved myocardial glucose metabolism. This review focuses on the dogma that GLP-1 receptor stimulation may provide beneficial cardiovascular effects, possibly due to enhanced myocardial energetic efficiency, by increasing myocardial glucose uptake. The published literature was systematically reviewed and the applied models evaluated since the outcomes of varying studies differ substantially. Reports on the effect of GLP-1R stimulation on myocardial metabolism are conflicting and should be evaluated carefully. There is limited and conflicting information on the impact of these agents in real life patients and while clinical outcome studies investigating the cardiovascular effects of GLP-1 based therapies have been initiated, the first two studies, both on DPP-4 inhibitors, designed specifically to evaluate cardiac safety reported largely neutral outcomes.

Original languageEnglish (US)
Pages (from-to)219-231
Number of pages13
JournalReviews in Endocrine and Metabolic Disorders
Volume15
Issue number3
DOIs
StatePublished - 2014

Fingerprint

Glucagon-Like Peptide 1
Dipeptidyl-Peptidase IV Inhibitors
Glucose
Incretins
Glucagon-Like Peptides
Outcome Assessment (Health Care)
Dipeptidyl Peptidase 4
Stroke Volume
Type 2 Diabetes Mellitus
Blood Glucose
Atherosclerosis
Cardiovascular Diseases
Ischemia
Perfusion
Body Weight
Hormones
Blood Pressure
Safety
Enzymes
Therapeutics

Keywords

  • GLP-1
  • Myocardial glucose metabolism

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Medicine(all)

Cite this

Impact of glucagon-like peptide-1 on myocardial glucose metabolism revisited. / Hansen, Jan; Brock, Birgitte; Bøtker, Hans Erik; Gjedde, Albert; Rungby, Jørgen; Gejl, Michael.

In: Reviews in Endocrine and Metabolic Disorders, Vol. 15, No. 3, 2014, p. 219-231.

Research output: Contribution to journalArticle

Hansen, Jan ; Brock, Birgitte ; Bøtker, Hans Erik ; Gjedde, Albert ; Rungby, Jørgen ; Gejl, Michael. / Impact of glucagon-like peptide-1 on myocardial glucose metabolism revisited. In: Reviews in Endocrine and Metabolic Disorders. 2014 ; Vol. 15, No. 3. pp. 219-231.
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