Novel Antidiabetic Agents and Their Effects on Lipid Profile: A Single Shot for Several Cardiovascular Targets

Int J Mol Sci. 2023 Jun 15;24(12):10164. doi: 10.3390/ijms241210164.

Abstract

Type-2 diabetes mellitus (DM) represents one of the most important risk factors for cardiovascular diseases (CVD). Hyperglycemia and glycemic variability are not the only determinant of the increased cardiovascular (CV) risk in diabetic patients, as a frequent metabolic disorder associated with DM is dyslipidemia, characterized by hypertriglyceridemia, decreased high-density lipoprotein (HDL) cholesterol levels and a shift towards small dense low-density lipoprotein (LDL) cholesterol. This pathological alteration, also called diabetic dyslipidemia, represents a relevant factor which could promotes atherosclerosis and subsequently an increased CV morbidity and mortality. Recently, the introduction of novel antidiabetic agents, such as sodium glucose transporter-2 inhibitors (SGLT2i), dipeptidyl peptidase-4 inhibitors (DPP4i) and glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1 RAs), has been associated with a significant improvement in CV outcomes. Beyond their known action on glycemia, their positive effects on the CV system also seems to be related to an ameliorated lipidic profile. In this context, this narrative review summarizes the current knowledge regarding these novel anti-diabetic drugs and their effects on diabetic dyslipidemia, which could explain the provided global benefit to the cardiovascular system.

Keywords: cardiovascular diseases; diabetes; dipeptidyl peptidase-4 inhibitors (DPP4i); dyslipidemia; glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1 RAs); sodium glucose transporter-2 inhibitors (SGLT2i).

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases* / complications
  • Cardiovascular Diseases* / etiology
  • Cardiovascular System* / metabolism
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / metabolism
  • Dipeptidyl-Peptidase IV Inhibitors* / pharmacology
  • Dyslipidemias* / complications
  • Dyslipidemias* / drug therapy
  • Glucagon-Like Peptide 1 / metabolism
  • Glucagon-Like Peptide-1 Receptor / agonists
  • Humans
  • Hypoglycemic Agents / pharmacology
  • Hypoglycemic Agents / therapeutic use
  • Lipids / pharmacology

Substances

  • Hypoglycemic Agents
  • Dipeptidyl-Peptidase IV Inhibitors
  • Glucagon-Like Peptide 1
  • Lipids
  • Glucagon-Like Peptide-1 Receptor

Grants and funding

This research received no external funding.