Physiology and Pharmacology of Effects of GLP-1-based Therapies on Gastric, Biliary and Intestinal Motility.

IF 3.3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Endocrinology Pub Date : 2024-11-26 DOI:10.1210/endocr/bqae155

Ryan J Jalleh, Chinmay S Marathe, Christopher K Rayner, Karen L Jones, Mahesh M Umapathysivam, Tongzhi Wu, Daniel R Quast, Mark P Plummer, Michael A Nauck, Michael Horowitz

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Abstract

Glucagon-like peptide-1 (GLP-1) receptor agonists and the dual GLP-1- and glucose-dependent insulinotropic polypeptide receptor co-agonist tirzepatide (referred to here collectively as "GLP-1-based therapy") are incretin-based therapies being used increasingly in the management of both type 2 diabetes and obesity. They are now recognized to have beneficial effects beyond improved glycemic control and weight loss, including cardiovascular and renal protection. GLP-1-based therapy also slows gastric emptying, which has benefits (lowering postprandial glucose), but also potential risks (eg, hypoglycemia in individuals on insulin or sulphonylurea therapy). Their effects on the gallbladder may also be beneficial, contributing to reducing postprandial triglycerides, but they also potentially increase the risk of biliary disease. In this review, we summarize the effects of GLP-1 and incretin-based therapeutics on gastric, biliary and small intestinal function. An improved understanding of these effects will optimize the use of these drugs.

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基于 GLP-1 的疗法对胃、胆道和肠道运动影响的生理学和药理学。

胰高血糖素样肽-1（GLP-1）受体激动剂（RAs）和双重 GLP-1 及葡萄糖依赖性胰岛素多肽（GIP）受体共同激动剂替扎帕肽（在此统称为 "GLP-1 类疗法"）是基于增量素的疗法，越来越多地用于治疗 2 型糖尿病（T2D）和肥胖症。除了改善血糖控制和减轻体重外，它们还具有保护心血管和肾脏等益处。以 GLP-1 为基础的疗法还能延缓胃排空，这有好处（降低餐后血糖），但也有潜在风险（例如，正在接受胰岛素或磺脲类药物治疗的人可能会出现低血糖）。它们对胆囊的影响也可能是有益的，有助于降低餐后甘油三酯，但也有可能增加胆道疾病的风险。在本综述中，我们总结了 GLP-1 和增量素类疗法对胃、胆和小肠功能的影响。加深对这些影响的了解将优化这些药物的使用。

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来源期刊

Endocrinology 医学-内分泌学与代谢

CiteScore

8.10

自引率

4.20%

发文量

195

审稿时长

2-3 weeks

期刊介绍： The mission of Endocrinology is to be the authoritative source of emerging hormone science and to disseminate that new knowledge to scientists, clinicians, and the public in a way that will enable "hormone science to health." Endocrinology welcomes the submission of original research investigating endocrine systems and diseases at all levels of biological organization, incorporating molecular mechanistic studies, such as hormone-receptor interactions, in all areas of endocrinology, as well as cross-disciplinary and integrative studies. The editors of Endocrinology encourage the submission of research in emerging areas not traditionally recognized as endocrinology or metabolism in addition to the following traditionally recognized fields: Adrenal; Bone Health and Osteoporosis; Cardiovascular Endocrinology; Diabetes; Endocrine-Disrupting Chemicals; Endocrine Neoplasia and Cancer; Growth; Neuroendocrinology; Nuclear Receptors and Their Ligands; Obesity; Reproductive Endocrinology; Signaling Pathways; and Thyroid.