Diabetes, Incretin Therapy and Thoracic Aortic Aneurysm - What Does the Evidence Show?

Current Vascular Pharmacology
Camilla Krizhanovskii, Anders Franco-Cereceda

Abstract

Epidemiological evidence supports a reduced prevalence of Thoracic Aortic Aneurysm (TAA) and Abdominal Aortic Aneurysm (AAA) in patients with Diabetes (DM). The mechanisms underlying this negative association are unknown. Some studies support that hyperglycemia has effects on the Extracellular Matrix (ECM), resulting in collagen cross-links and altered proteolytic activity, which ultimately counteracts aneurysm formation. However, recent experimental research indicates that incretin- based anti-diabetic therapy and Glucagon-Like Peptide-1 (GLP-1) may reduce the formation of TAA. GLP-1 is a peptide hormone, released from intestinal L-cells in response to hormonal, neural and nutrient stimuli. In addition to potentiation of meal-stimulated insulin secretion, GLP-1 signaling exerts numerous pleiotropic effects on various tissues, including protective effects on the myocardium and vascular endothelium. Recent studies also report protective effects of GLP-1 based therapy on the formation of aneurysms in animal models and direct effects of GLP-1 signaling on the molecular mechanisms suggested to influence TAA formation, including inflammation, proteolytic activity and collagen composition. In this narrative review, we present the ava...Continue Reading

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Citations

Aug 29, 2020·VASA. Zeitschrift für Gefässkrankheiten·Sigrid NikolChristine Espinola-Klein
Aug 17, 2019·Current Vascular Pharmacology·M C Vázquez, L Sobrevia

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