Biomedicine & Pharmacotherapy (May 2023)

Comparative effects of glucagon-like peptide-1 receptors agonists, 4-dipeptidyl peptidase inhibitors, and metformin on metabolic syndrome

  • Cristina Bouzas,
  • Rosario Pastor,
  • Silvia Garcia,
  • Margalida Monserrat-Mesquida,
  • Miguel Ángel Martínez-González,
  • Jordi Salas-Salvadó,
  • Dolores Corella,
  • Albert Goday,
  • J. Alfredo Martínez,
  • Ángel M. Alonso-Gómez,
  • Olga Fernández-Barceló,
  • Jesús Vioque,
  • Dora Romaguera,
  • José Lopez-Miranda,
  • Ramón Estruch,
  • Francisco J. Tinahones,
  • José Lapetra,
  • Lluís Serra-Majem,
  • Blanca Riquelme-Gallego,
  • Vicente Martín-Sánchez,
  • Xavier Pintó,
  • Miguel Delgado-Rodriguez,
  • Pilar Matía,
  • Josep Vidal,
  • Jersy-Jair Cardenas-Salas,
  • Lidia Daimiel,
  • Emilio Ros,
  • Estefanía Toledo,
  • Josep M. Manzanares,
  • Inmaculada Gonzalez-Monge,
  • Miguel-Ángel Muñoz,
  • Diego Martinez-Urbistondo,
  • Lucas Tojal-Sierra,
  • Carlos Muñoz-Bravo,
  • Salvador Miralles-Gisbert,
  • Marian Martin,
  • Antonio García-Ríos,
  • Sara Castro-Barquero,
  • José Carlos Fernández-García,
  • José Manuel Santos-Lozano,
  • F. Javier Basterra-Gortari,
  • Liliana Gutiérrez-Carrasquilla,
  • Patricia Guillem-Saiz,
  • Alba Satorres,
  • Itziar Abete,
  • Carolina Sorto-Sanchez,
  • Javier Díez-Espino,
  • Nancy Babio,
  • Montse Fitó,
  • Josep A. Tur

Journal volume & issue
Vol. 161
p. 114561

Abstract

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Aims: To assess the comparative effects of glucagon-like peptide-1 receptor agonists (GLP-1RA), 4-dipeptidyl peptidase inhibitors (DPP-4I), and metformin treatment during one year on metabolic syndrome (MetS) components and severity in MetS patients. Methods: Prospective study (n = 6165 adults) within the frame of PREDIMED-Plus trial. The major end-point was changes on MetS components and severity after one- year treatment of GLP-1RA, DPP-4I, and metformin. Anthropometric measurements (weight, height and waist circumference), body mass index (BM), and blood pressure were registered. Blood samples were collected after overnight fasting. Plasma glucose, glycosylated hemoglobin (HbA1c), plasma triglycerides and cholesterol were measured. Dietary intakes as well as physical activity were assessed through validated questionnaires. Results: MetS parameters improved through time. The treated groups improved glycaemia compared with untreated (glycaemia ∆ untreated: −1.7 mg/dL(± 13.5); ∆ metformin: − 2.5(± 23.9) mg/dL; ∆ DPP-4I: − 4.5(± 42.6); mg/dL ∆ GLP-1RA: − 4.3(± 50.9) mg/dL; and HbA1c: ∆ untreated: 0.0(± 0.3) %; ∆ metformin: − 0.1(± 0.7) %; ∆ DPP-4I: − 0.1(± 1.0) %; ∆ GLP-1RA: − 0.2(± 1.2) %. Participants decreased BMI and waist circumference. GLP-1RA and DPP-4I participants registered the lowest decrease in BMI (∆ untreated: −0.8(± 1.6) kg/m2; ∆ metformin: − 0.8(± 1.5) kg/m2; ∆ DPP-4I: − 0.6(± 1.3) kg/m2; ∆ GLP-1RA: − 0.5(± 1.2) kg/m2. and their waist circumference (∆ untreated: −2.8(± 5.2) cm; ∆ metformin: − 2.6(± 15.2) cm; ∆ DPP-4I: − 2.1(± 4.8) cm; ∆ GLP-1RA: − 2.4(± 4.1) cm. Conclusion: In patients with MetS and healthy lifestyle intervention, those treated with GLP-1RA and DPP-4I obtained better glycemic profile. Anthropometric improvements were modest.

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