Effect of the Glucagon-Like Peptide-1 Receptor Agonists on Autonomic Function in Subjects with Diabetes: A Systematic Review and Meta-Analysis.

Humans Autonomic Nervous System Diabetes Mellitus, Type 2 / drug therapy Glucagon-Like Peptide 1 Glucagon-Like Peptide-1 Receptor / agonists
Autonomic nervous system Diabetes mellitus Diabetic neuropathies Glucagon-like peptide-1 receptor Heart rate

Journal

Diabetes & metabolism journal
ISSN: 2233-6087
Titre abrégé: Diabetes Metab J
Pays: Korea (South)
ID NLM: 101556588

Informations de publication

Date de publication:
11 2022
Historique:
received: 10 11 2021
accepted: 20 01 2022
pubmed: 13 4 2022
medline: 6 12 2022
entrez: 12 4 2022
Statut: ppublish

Résumé

In addition to the metabolic effects in diabetes, glucagon-like peptide 1 receptor (GLP-1R) agonists lead to a small but substantial increase in heart rate (HR). However, the GLP-1R actions on the autonomic nervous system (ANS) in diabetes remain debated. Therefore, this meta-analysis evaluates the effect of GLP-1R agonist on measures of ANS function in diabetes. According to the Cochrane Collaboration and Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, we conducted a meta-analysis considering clinical trials in which the autonomic function was evaluated in diabetic subjects chronically treated with GLP-1R agonists. The outcomes were the change of ANS function measured by heart rate variability (HRV) and cardiac autonomic reflex tests (CARTs). In the studies enrolled, HR significantly increased after treatment (P<0.001), whereas low frequency/high frequency ratio did not differ (P=0.410); no changes in other measures of HRV were detected. Considering CARTs, only the 30:15 value derived from lying-to-standing test was significantly lower after treatment (P=0.002), but only two studies reported this measurement. No differences in other CARTs outcome were observed. The meta-analysis confirms the HR increase but seems to exclude an alteration of the sympatho-vagal balance due to chronic treatment with GLP-1R agonists in diabetes, considering the available measures of ANS function.

Sections du résumé

BACKGROUND
In addition to the metabolic effects in diabetes, glucagon-like peptide 1 receptor (GLP-1R) agonists lead to a small but substantial increase in heart rate (HR). However, the GLP-1R actions on the autonomic nervous system (ANS) in diabetes remain debated. Therefore, this meta-analysis evaluates the effect of GLP-1R agonist on measures of ANS function in diabetes.
METHODS
According to the Cochrane Collaboration and Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, we conducted a meta-analysis considering clinical trials in which the autonomic function was evaluated in diabetic subjects chronically treated with GLP-1R agonists. The outcomes were the change of ANS function measured by heart rate variability (HRV) and cardiac autonomic reflex tests (CARTs).
RESULTS
In the studies enrolled, HR significantly increased after treatment (P<0.001), whereas low frequency/high frequency ratio did not differ (P=0.410); no changes in other measures of HRV were detected. Considering CARTs, only the 30:15 value derived from lying-to-standing test was significantly lower after treatment (P=0.002), but only two studies reported this measurement. No differences in other CARTs outcome were observed.
CONCLUSION
The meta-analysis confirms the HR increase but seems to exclude an alteration of the sympatho-vagal balance due to chronic treatment with GLP-1R agonists in diabetes, considering the available measures of ANS function.

Identifiants

DOI: 10.4093/dmj.2021.0314 PMID: 35410110 PMC: PMC9723196
pubmed: 35410110
pii: dmj.2021.0314
doi: 10.4093/dmj.2021.0314
pmc: PMC9723196
doi:

Substances chimiques

Glucagon-Like Peptide 1 89750-14-1
Glucagon-Like Peptide-1 Receptor 0
GLP1R protein, human 0

Types de publication

Meta-Analysis Systematic Review Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

901-911

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Auteurs

Carla Greco (C)

Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Unit of Endocrinology, Department of Medical Specialties, Baggiovara Hospital, University Hospital of Modena, Modena, Italy.

Daniele Santi (D)

Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Unit of Endocrinology, Department of Medical Specialties, Baggiovara Hospital, University Hospital of Modena, Modena, Italy.

Giulia Brigante (G)

Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Unit of Endocrinology, Department of Medical Specialties, Baggiovara Hospital, University Hospital of Modena, Modena, Italy.

Chiara Pacchioni (C)

Unit of Endocrinology, Department of Medical Specialties, Baggiovara Hospital, University Hospital of Modena, Modena, Italy.

Manuela Simoni (M)

Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Unit of Endocrinology, Department of Medical Specialties, Baggiovara Hospital, University Hospital of Modena, Modena, Italy.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Effect of the Glucagon-Like Peptide-1 Receptor...
questionsmedicales.fr › Système nerveux › Système nerveux périphérique › Système nerveux autonome › Effect of the Glucagon-Like Peptide-1 Receptor...
questionsmedicales.fr › Maladies endocriniennes › Diabète › Diabète de type 2 › Effect of the Glucagon-Like Peptide-1 Receptor...
questionsmedicales.fr › Hormones gastrointestinales › Peptides glucagon-like › Glucagon-like peptide 1 › Effect of the Glucagon-Like Peptide-1 Receptor...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Protéines membranaires › Récepteurs de surface cellulaire › Récepteurs peptidiques › Récepteur hormone gastrointestinale › Récepteurs des peptides similaires au glucagon › Récepteur du peptide-1 similaire au glucagon › Effect of the Glucagon-Like Peptide-1 Receptor...