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Original Article
- Complications
- Effect of the Glucagon-Like Peptide-1 Receptor Agonists on Autonomic Function in Subjects with Diabetes: A Systematic Review and Meta-Analysis
- Carla Greco, Daniele Santi, Giulia Brigante, Chiara Pacchioni, Manuela Simoni
- Diabetes Metab J. 2022;46(6):901-911. Published online April 12, 2022
- DOI: https://doi.org/10.4093/dmj.2021.0314
- 5,858 View
- 285 Download
- 10 Web of Science
- 12 Crossref
-
Abstract
PDF
Supplementary Material
PubReader 
ePub - 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. -
Citations
Citations to this article as recorded by
- Heart and health behavior responses to GLP-1 receptor agonists: a 12-wk study using wearable technology and causal inference
Gregory J. Grosicki, Jeongeun Kim, Finn Fielding, Summer R. Jasinski, Christopher Chapman, William von Hippel, Kristen E. Holmes
American Journal of Physiology-Heart and Circulatory Physiology.2025; 328(2): H235. CrossRef - Liraglutide does not increase heart rate of diabetic patients during acute myocardial infarction
Qianyi Li, Chunxuan Wu, Shiqun Sun, Lingchao Yang, Yanyan Li, Yixin Niu, Li Zhang, Wei Li, Ying Yu
Journal of Diabetes.2024;[Epub] CrossRef - A randomized, double‐blind trial assessing the efficacy and safety of two doses of dulaglutide in Japanese participants with type 2 diabetes (AWARD‐JPN)
Tomoaki Morioka, Masakazu Takeuchi, Akichika Ozeki, Masanori Emoto
Diabetes, Obesity and Metabolism.2024; 26(8): 3167. CrossRef - Cardiovascular autonomic neuropathy in diabetes: an update with a focus on management
Aikaterini Eleftheriadou, Vincenza Spallone, Abd A. Tahrani, Uazman Alam
Diabetologia.2024; 67(12): 2611. CrossRef - Autonomic Nervous System: A Therapeutic Target for Cardiac End-Organ Damage in Hypertension
Lisa A. Gottlieb, Felix Mahfoud, Stavros Stavrakis, Thomas Jespersen, Dominik Linz
Hypertension.2024; 81(10): 2027. CrossRef - Effect of the glucagon‐like peptide‐1 receptor agonists on diabetic peripheral neuropathy: A meta‐analysis
Shujin Fan, Yue Qiu, Jing Liu, Tianxin Zhu, Chuan Wang, Dan Liu, Li Yan, Meng Ren
Journal of Neurochemistry.2024;[Epub] CrossRef - Remodeling of the Intracardiac Ganglia During the Development of Cardiovascular Autonomic Dysfunction in Type 2 Diabetes: Molecular Mechanisms and Therapeutics
Anthony J. Evans, Yu-Long Li
International Journal of Molecular Sciences.2024; 25(22): 12464. CrossRef - Hormonal Gut–Brain Signaling for the Treatment of Obesity
Eun Roh, Kyung Mook Choi
International Journal of Molecular Sciences.2023; 24(4): 3384. CrossRef - Effects of new hypoglycemic drugs on cardiac remodeling: a systematic review and network meta-analysis
Yi-lin Huang, Xiao-zhuo Xu, Jing Liu, Pin-yao Wang, Xue-li Wang, Hong-lin Feng, Cheng-jiang Liu, Xu Han
BMC Cardiovascular Disorders.2023;[Epub] CrossRef - Obesity and hypertension: Obesity medicine association (OMA) clinical practice statement (CPS) 2023
Tiffany Lowe Clayton, Angela Fitch, Harold Edward Bays
Obesity Pillars.2023; 8: 100083. CrossRef - Incretins and microvascular complications of diabetes: neuropathy, nephropathy, retinopathy and microangiopathy
Jonathan Goldney, Jack A. Sargeant, Melanie J. Davies
Diabetologia.2023; 66(10): 1832. CrossRef - Diabetes-Induced Cardiac Autonomic Neuropathy: Impact on Heart Function and Prognosis
Susumu Z. Sudo, Tadeu L. Montagnoli, Bruna de S. Rocha, Aimeé D. Santos, Mauro P. L. de Sá, Gisele Zapata-Sudo
Biomedicines.2022; 10(12): 3258. CrossRef
- Heart and health behavior responses to GLP-1 receptor agonists: a 12-wk study using wearable technology and causal inference
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