Long-term observational study on the impact of GLP-1R agonists on lung function in diabetic patients

Respir Med. 2019 Jul-Aug:154:86-92. doi: 10.1016/j.rmed.2019.06.015. Epub 2019 Jun 18.

Abstract

Introduction: Preclinical research suggests a role of Glucagon Like Peptide-1 Receptors (GLP-1R) on the regulation of human bronchial tone. We investigated the effect of GLP-1R agonists on lung function of Type 2 Diabetes Mellitus (T2DM) population without co-existing chronic obstructive respiratory disorders.

Methods: This was a prospective cohort study that examined change in lung function measurements over two years of T2DM patients (n = 32) treated with metformin monotherapy (control cohort), metformin plus GLP-1R agonists (GLP-1R agonists cohort), or metformin plus insulin (insulin cohort).

Results: After 24 months of treatment, the forced expiratory volume in 1 s (FEV1) significantly (p < 0.05) increased from baseline in the GLP-1R agonists cohort (218 ml [95%CI 88-246]), but not in the control and insulin cohorts (94 ml [95%CI -28 - 216] and 26 ml [95%CI -174 - 226], respectively; p > 0.05 vs. baseline). The average increase in FEV1 in the GLP-1R agonists cohort was significantly greater than that in the control and insulin cohorts (delta: 110 ml [95%CI 18-202] and 177 ml [95%CI 85-270], respectively, p < 0.05). The forced vital capacity (FVC) also increased significantly more in the GLP-1R agonists cohort than in the control and insulin cohorts (overall delta FVC: 183 ml [95%CI 72-295], p < 0.05). The maximal expiratory flow at 50-75% significantly (p < 0.05) improved from baseline in the GLP-1R agonists cohort, but not in the control and insulin cohorts (p > 0.05).

Conclusion: Our preliminary results suggest a potential new therapeutic perspective to treat airway disorders with GLP-1R agonists.

Keywords: Airway smooth muscle; Glucagon like Peptide-1 receptors; Lung function; Type 2 diabetes mellitus.

Publication types

  • Clinical Trial
  • Observational Study

MeSH terms

  • Aged
  • Bronchi / drug effects*
  • Case-Control Studies
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Drug Therapy, Combination
  • Female
  • Forced Expiratory Volume / drug effects
  • Glucagon-Like Peptide-1 Receptor Agonists*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Italy / epidemiology
  • Lung / physiopathology*
  • Male
  • Maximal Expiratory Flow Rate / drug effects
  • Metformin / therapeutic use
  • Middle Aged
  • Prospective Studies
  • Respiratory Function Tests / methods
  • Vital Capacity / drug effects

Substances

  • Hypoglycemic Agents
  • Insulin
  • Metformin
  • Glucagon-Like Peptide-1 Receptor Agonists