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In recent years, glucagon-like peptide-1 receptor agonists (GLP-1RA) have been well known
as diabetes treatment.
However, GLP-1 receptors are not only present in pancreatic cells, but also in the gastrointestinal tract, heart, skin, nervous system, etc.
) promote glycogen synthesis and fat production of corresponding tissues through receptor binding, so as to achieve antihypertensive, lipid-lowering and cardiovascular system protection;
➤ Acts on the central nervous system, enhances learning and memory functions to protect the nerves
.
Therefore, in addition to the heart, kidney and weight loss benefits brought by hypoglycemic GLP-1RA, researchers are also actively exploring the role of
GLP-1RA in other diseases.
1.
Non-alcoholic fatty liver disease
chronic liver disease worldwide.
GLP-1RA (such as liraglutide, semeglutide, dulaglutide, etc.
) and sodium-glucose co-transporter 2 inhibitors (SGLT2i, such as empagliflozin and dapagliflozin) can be recommended for patients with type 2 diabetes mellitus (T2DM) and nonalcoholic steatohepatitis to achieve the comprehensive management goals of patients with lipid reduction and weight control, thereby reducing the risk of progression of
nonalcoholic fatty liver disease.
2.
Alzheimer's disease and Parkinson's disease
Alzheimer's disease and Parkinson's disease are both diabetes-related neurodegenerative diseases
.
GLP-1RA has a protective mechanism of nerves, and meta-analysis shows that although the central protective mechanism of GLP-1RA needs to be clarified, there is clinical evidence that GLP-1RA has the effect
of treating Alzheimer's disease and Parkinson's disease.
The evidence and possible mechanism by which liraglutide improves Alzheimer's disease lies in the fact that the drug has a nootropic effect in Alzheimer's disease / mild cognitive impairment, improves intrinsic connectivity in brain regions, increases blood-brain glucose transport capacity with liraglutide for 6 months, and improves short-term memory and memory complexes
in treated patients.
The exploratory analysis results of the REWIND study suggest that dulaglutide can reduce the risk of
developing cognitive impairment in patients aged 50 years or older with T2DM.
3.
Polycystic ovary syndrome
.
Studies in patients with PCOS have shown that exenatide and liraglutide alone or in combination with metformin may be a good option
for the treatment of PCOS and its complications.
The effect of liraglutide combined with metformin in improving polycystic ovary syndrome was better than that of metformin, but the incidence of gastrointestinal adverse reactions in the liraglutide combined with metformin group was significantly higher than that in the metformin group
.
Therefore, attention should be paid to the medication method during treatment to reduce the incidence of
adverse reactions.
Similar findings
have been made in animal studies conducted on dulaglutide.
The efficacy of GLP-1RA in patients with PCOS still needs further research to evaluate
.
Reference:PAN Qi, GUO Lixin.
Development history and clinical application progress of glucagon-like peptide-1 receptor agonists[J].
Chinese Journal of Diabetes, 2022, 14(12): 1355-1363
