Lipid Profile Changes Associated with SGLT-2 Inhibitors and GLP-1 Agonists in Diabetes and Metabolic Syndrome

Authors

Resmi Premji, Montage Medical Group, Monterey, California, USA.
Eric S. Nylen, Department of Endocrinology, VAMC and George Washington University School of Medicine, Washington, District of Columbia, USA.
Nejat Naser, Department of Endocrinology, VAMC and George Washington University School of Medicine, Washington, District of Columbia, USA.
Shruti Gandhi, Department of Endocrinology, VAMC and George Washington University School of Medicine, Washington, District of Columbia, USA.
Kenneth D. Burman, Department of Endocrinology, Georgetown University School of Medicine, Washington Hospital Center, Washington, District of Columbia, USA.
Sabyasachi Sen, Department of Endocrinology, VAMC and George Washington University School of Medicine, Washington, District of Columbia, USA.

Document Type

Journal Article

Publication Date

4-22-2022

Journal

Metabolic syndrome and related disorders

DOI

10.1089/met.2022.0004

Keywords

CVOT; HDL; LDL; SGLT2 inhibitors; diabetes; glucagon like peptide-1 agonist; triglycerides

Abstract

The introduction of sodium glucose transporter-2 inhibitors and glucagon-like peptide-1 receptor agonists in type 2 diabetes mellitus treatment has shown an unexpectedly significant improvement in heart disease outcome trials. Although they have very different modes of action, a portion of the salutary cardiovascular disease improvement may be related to their impact on diabetic dyslipidemia. As discussed in this focused review, the sodium glucose transporter-2 inhibitors as a class show a mild increase in low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol levels, while triglycerides (TG) decrease inconsistently. In particular, the rise in LDL appears to be related to the less atherogenic, large buoyant LDL particles. The glucagon-like peptide-1 receptor agonists show more of an impact on weight loss and improvement in the underlying low HDL and high TG dyslipidemia. The effect of sodium glucose transporter-2 inhibitors and glucagon-like peptide 1 receptor agonists when used in combination remains largely unknown. Also unexplored is difference in effect of these medications among various ethnicities and metabolic syndrome.

APA Citation

Premji, Resmi; Nylen, Eric S.; Naser, Nejat; Gandhi, Shruti; Burman, Kenneth D.; and Sen, Sabyasachi, "Lipid Profile Changes Associated with SGLT-2 Inhibitors and GLP-1 Agonists in Diabetes and Metabolic Syndrome" (2022). GW Authored Works. Paper 759.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/759

Department

Medicine