GLP-1 Receptor Agonists Are Associated with Reduced Ascending Aorta Dilatation in Patients with Type 2 Diabetes: A Prospective Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: AIMS-To assess the impact of GLP-1 receptor agonist (GLP-1 RA) treatment on the progression of ascending aortic dilatation in patients with type 2 diabetes mellitus (T2DM), investigated with computed tomography angiography (CTA) and circulating biomarkers reflecting vascular remodeling. METHODS-A total of 127 T2DM patients with subclinical ascending aortic dilatation (diameter 35 mm < and ≤ 45 mm) were prospectively enrolled in this study. All were first-line naïve to GLP-1 RA. Fifty-seven patients started GLP-1 RA treatment (liraglutide, semaglutide, or dulaglutide) and 70 remained in routine care as controls. CTA was performed at baseline and 24 months to measure the ascending aortic diameter. Matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinases-1 (TIMP-1), C-reactive protein (CRP) and osteoprotegerin (OPG) were evaluated from sera at these two time points. RESULTS-The GLP-1 RA recipients, compared with controls, had the more limited progression of aortic dilatation (mean change, +0.36±0.20 mm vs+1.05±0.28 mm; P<0.001) at 24 months. Therapy correlated with decreased MMP-9 and CRP (P<0.01) and increased TIMP-1 and OPG (P<0.05). The use of GLP-1 RA was an independent predictor of low progression, even in multivariate models after adjusting for demographic, metabolic, and biomarker data. CONCLUSIONS-GLP-1 receptor agonist therapy has been associated with reduced ascending aortic dilatation in T2DM, suggesting a vasoprotective action beyond glucose lowering.
DOI: 10.3390/ijms26209977
Authors: Celestino Sardu, Ludovica Vittoria Marfella, Carlo Fumagalli, Luca Rinaldi, Ferdinando Carlo Sasso, Domenico Cozzolino, Francesco Nappo, Ausilia Sellitto, Ciro Romano, Caterina Carusone, Pasquale Russo, Lorenza Marfella, Nicola Maria Tarantino, Gerardo Carpinella, Fulvio Furbatto, Sandro Gentile, Giuseppina Guarino, Ersilia Satta, Alessandro Bellis, Luca Marinelli, Isabella Donisi, Nunzia D’Onofrio², Ciro Mauro, Salvatore Cappabianca, Maria Luisa Balestrieri, Raffaele Marfella
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,499
OpenAlex ID: W4415369226