GLP-1 Receptor Agonists Are Associated with Reduced Ascending Aorta Dilatation in Patients with Type 2 Diabetes: A Prospective Study
The aim was to assess the impact of glucagon-like peptide-1 receptor agonists (GLP-1 RA) treatment on the progression of ascending aorta dilatation in patients with type 2 diabetes mellitus (T2DM). A total of 127 T2DM patients with subclinical ascending aortic dilatation (35-45 mm) were prospectively enrolled. Fifty-seven initiated GLP-1 RA therapy (liraglutide, semaglutide, or dulaglutide), while 70 continued on standard care. Ascending aortic diameter was measured by computed tomography angiography (CTA) at baseline and 24 months, alongside circulating markers of vascular remodeling: matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinases-1 (TIMP-1), C-reactive protein (CRP), and osteoprotegerin (OPG). Progression of aortic dilatation was significantly lower in the GLP-1 RA group compared with controls (+0.36 ± 0.20 mm vs. +1.05 ± 0.28 mm; <i>p</i> < 0.001). Therapy correlated with decreased MMP-9 and CRP (<i>p</i> < 0.01) and increased TIMP-1 and OPG (<i>p</i> < 0.05). The use of GLP-1 RA was an independent predictor of low progression, even in multivariate models after adjusting for demographic, metabolic, and biomarker data. GLP-1 RA therapy was associated with reduced progression of ascending aortic dilatation in T2DM, supporting a potential vasoprotective role beyond glucose lowering.
Authors
- Luca Rinaldi (ORCID: https://orcid.org/0000-0002-6541-3821)
- Caterina Carusone
- Ciro Romano (ORCID: https://orcid.org/0000-0002-5807-6601)
- Lorenza Marfella
- Raffaele Marfella (ORCID: https://orcid.org/0000-0003-3960-9270)
- Ludovica Vittoria Marfella
- Fulvio Furbatto
- Salvatore Cappabianca (ORCID: https://orcid.org/0000-0002-5417-2268)
- Maria Luisa Balestrieri (ORCID: https://orcid.org/0000-0001-6001-1789)
- Nunzia D’Onofrio (ORCID: https://orcid.org/0000-0002-5300-9530)
- Ciro Mauro (ORCID: https://orcid.org/0000-0003-3611-2330)
- Luca Marinelli (ORCID: https://orcid.org/0000-0001-7775-5952)
- Pasquale Russo (ORCID: https://orcid.org/0000-0002-6733-9573)
- Ferdinando Carlo Sasso (ORCID: https://orcid.org/0000-0002-9142-7848)
- S Gentile
- Alessandro Bellis (ORCID: https://orcid.org/0000-0003-3476-5696)
- Nicola Tarantino (ORCID: https://orcid.org/0000-0002-9770-8675)
- Giuseppina Guarino (ORCID: https://orcid.org/0000-0002-5057-9650)
- Francesco Nappo
- Gerardo Carpinella
- Ersilia Satta (ORCID: https://orcid.org/0000-0001-8154-287X)
- Celestino Sardu (ORCID: https://orcid.org/0000-0001-5099-3790)
- Carlo Fumagalli (ORCID: https://orcid.org/0000-0001-7963-5049)
- Isabella Donisi
- Domenico Cozzolino (ORCID: https://orcid.org/0000-0003-4968-8160)
- Ausilia Sellitto
Institutions
- University of Campania "Luigi Vanvitelli" (IT)
- Ospedale Antonio Cardarelli (IT)
- University of Campania "Luigi Vanvitelli" (IT)
- NIHR Research Delivery Network (GB)
Publication Details
- Journal
- International Journal of Molecular Sciences
- Published
- 2025-10-14
- DOI
- https://doi.org/10.3390/ijms26209977
- Citations
- 3
- Primary Topic
- Diabetes Treatment and Management
- Type
- article
- Field-Weighted Citation Impact
- 3.88