Lipid profile changes induced by glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes: a systematic review and network meta-analysis

ABSTRACT

Objective

This study was conducted to investigate the effects of glucagon-like peptide-1 receptor (GLP-1) agonists on the lipid profiles of patients with type 2 diabetes.

Methods

We retrieved the data of phase 3 randomized controlled trials on GLP-1 agonists in patients with type 2 diabetes from the PubMed, Embase, and Cochrane library up to 11 February 2024. We extracted % changes in low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol/total cholesterol (T-CHO) and triglycerides levels from baseline. Using Bayesian network meta-analysis, mean differences and 95% credible intervals for lipid changes were estimated as a unit of percentage points (%p) by class.

Results

Twenty-six studies covering 22,290 participants were included. The glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 dual agonist showed significant differences in LDL-C (range of mean differences: −11.61 to −6.77%p), triglycerides (−19.94 to −13.31%p), and T-CHO (−7.94 to −5.09%p) levels compared to placebo, insulin, and sodium-glucose co-transporter 2 (SGLT2) inhibitors. The GLP-1 agonist significantly reduced T-CHO (−5.20%p; −6.39%p) and LDL-C (−4.32%p; −8.17%p) levels compared to placebo and SGLT2 inhibitors, respectively.

Conclusions

The GIP/GLP-1 dual agonist positively affects the lipid profiles of patients with type 2 diabetes. This may contribute to a lower risk of cardiovascular disease in patients with type 2 diabetes.

Protocol registration

PROSPERO (CRD42021282668)

KEYWORDS:

• Type 2 diabetes mellitus
• glucagon-like peptide-1
• gastric inhibitory polypeptide
• glucose-dependent insulinotropic polypeptide
• cholesterol
• triglycerides

Declaration of interests

EK Lee received a grant from Lilly, Korea. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Conception and design of the work: Y Chae, SH Kwon, and EK Lee; Acquisition of data: Y Chae, SH Kwon, E Kang, J Im, HJ Kim, and EK Lee; Analysis of data: Y Chae, SH Kwon, JH Nam, and EK Lee; Interpretation of data: Y Chae, SH Kwon, JH Nam, EK Lee; Drafting the work or reviewing it critically: all; Agreeing on the journal to which the article will be published: all; Reviewing/agreeing on all versions of manuscripts: all.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17512433.2024.2363838

Additional information

Funding

This paper was not funded.