Impact of GLP-1 receptor agonists on cardiovascular risk reduction in patients with obesity without type 2 diabetes mellitus: a systematic review
DOI:
https://doi.org/10.18203/2320-6012.ijrms20261347Abstract
Obesity has been established as an independent cardiovascular risk factor, driving low-grade systemic inflammation and endothelial dysfunction. Recently, GLP-1 receptor agonists (GLP-1 RAs) have demonstrated pleiotropic cardioprotective benefits, raising a paradigm shift regarding their preventive utility in patients without a diagnosis of type 2 diabetes mellitus (T2DM). To evaluate the current scientific evidence on the efficacy of GLP-1 RAs in reducing major adverse cardiovascular events (MACE) and improving risk biomarkers in overweight or obese patients without T2DM. A systematic literature review (2019-2026) was conducted in PubMed, Scopus, and Cochrane Library databases. Large-scale randomized clinical trials, meta-analyses, and mechanistic studies evaluating GLP-1 RA interventions (such as semaglutide and liraglutide) in non-diabetic populations were included, analyzing MACE incidence, lipid profiles, and inflammatory markers. Evidence demonstrates that GLP-1 RA therapy significantly reduces the incidence of MACE (non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death) in this population, with relative risk reductions approaching 20%. Crucially, independent of the magnitude of weight loss, consistent improvements are observed in endothelial function, a sharp decrease in high-sensitivity C-reactive protein (hs-CRP), optimization of the lipid profile, and reduction in systolic blood pressure. GLP-1 RAs transcend glycemic control and simple anthropometric intervention, positioning themselves as a primary cardiovascular risk-modifying therapy. Their application in obese patients without T2DM represents a critical advance toward cardiovascular prevention driven by comprehensive metabolic pharmacotherapy. control, positioning itself as a promising strategy for diabetes and obesity management.
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