Glucagon like peptide-1 Receptor Agonist (GLP-1RA) merupakan salah satu agen incretin based therapy. GLP-1RA sudah direkomendasikan oleh American Diabetes Association dan European Association for The Study of Diabetes sebagai opsi lini kedua untuk penatalaksanaan diabetes tipe 2.[1,2]
Inkretin merupakan hormon yang disekresi oleh sel-sel di midgut yang akan mempotensiasi glucose-dependent insulin secretion. GLP-1 endogen/alami dihasilkan oleh gen proglukagon pada sel L di usus halus dan disekresi sebagai respon terhadap intake glukosa. GLP-1 berikatan secara spesifik pada reseptor GLP-1, reseptor ini diekspresikan pada sejumlah jaringan yakni sel beta pankreas, duktus pankreas, mukosa gaster, ginjal, paru, jantung, hepar, kulit, sel imun dan hipotalamus.
Dalam kerjanya, GLP-1 alami mempunyai waktu paruh yang pendek (sekitar 1-2 menit) karena mengalami degradasi oleh enzim dipeptidil peptidase-4 (DPP-4).[3–5]
(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)
Referensi
1. Li et al. Glucagon-like peptide-1 receptor agonists and heart failure in type 2 diabetes: systematic review and meta-analysis of randomized and observational studies. BMC Cardiovascular Disorders .2016;16:91. DOI 10.1186/s12872-016-0260-0
2. Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E et al. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2015;38(1):140–9.
3. Olmo-Garcia MI, Merino-Torres JF. GLP-1 Receptor Agonists and Cardiovascular Disease in Patients with Type 2 Diabetes. J Diabetes Res. 2018 Apr 2;2018:4020492. doi: 10.1155/2018/4020492.
4. Dungan K, DeSantis A. Glucagon-like peptide-1 receptor agonists for the treatment of type 2 diabetes mellitus. UpToDate. 2024. https://www.uptodate.com/contents/glucagon-like-peptide-1-receptor-agonists-for-the-treatment-of-type-2-diabetes-mellitus
5. Shyangdan DS, Royle P, Clar C, et al. Glucagon-like peptide analogues for type 2 diabetes mellitus. Cochrane Database Syst Rev 2011; :CD006423.
6. Kenneth B et al. GLP-1 Agonist Therapy for Advanced Heart Failure With Reduced Ejection Fraction. Circ Heart Fail. 2014;7:673-679. DOI: 10.1161/CIRCHEARTFAILURE.114.000346
7. Sposito AC et al. GLP‑1RAs in type 2 diabetes: mechanisms that underlie cardiovascular effects and overview of cardiovascular outcome data.Cardiovasc Diabetol (2018) 17:157 https://doi.org/10.1186/s12933-018-0800-2
8. Scheen AJ. GLP1 receptor agonists and heart failure in diabetes. Diabetes Metab. 2017 Apr;43 Suppl 1:2S132S19. DOI: 10.1016/S12623636(17)30068X
9. Geesje M, Dalingga T, Max N. GLP1, an Important Regulator of Intestinal Lipid Metabolism. Arterioscler Thromb Vasc Biol. 2015;35:1048-1049. DOI: 10.1161/ATVBAHA.115.305479.
10. Patel VJ, Joharapurkar AA, Shah Gb, Jain MR. Effect of GLP-1 based therapies on diabetic dyslipidemia. Curr Diabetes Rev.2014;10(4):238-50.
11. Hasegawa Y, Hori M, Nakagami T, Harada-Shiba M, Uchigata Y. Glucagon like Peptide-1 receptor agonists reduced the low density lipoprotein cholesterol in Japanese patients with type 2 diabetes mellitus treated with statins. J Clin Lipidol. 2018 Jan Feb;12(1):6269. e1. doi: 10.1016/j.jacl.2017.11.006.
12. Dhir G, Kenneth C. Glucagon like peptide-1 receptor agonists for the management of obesity and non-alcoholic fatty liver disease: a novel therapeutic option. J Investig Med 2018;66:7–10. doi:10.1136/jim-2017-000554
13. Visboll T, Christensen M, Junker AE, Knop FK, Gluud LL. Effects of glucagon-like peptide-1 receptor agonists on weight loss: systematic review and meta-analyses of randomised controlled trials. BMJ. 2012 Jan 10;344:d7771. doi: 10.1136/bmj.d7771.
14. Lee J, Hong SW, Rhee EJ, Lee WY. GLP-1 Receptor Agonist and Non-Alcoholic Fatty Liver Disease. Diabetes Metab J 2012;36:262-267. http://dx.doi. org/10.4093/dmj.2012.36.4.262
15. Sanchez PP, Cusi K. Treatment of Nonalcoholic Fatty Liver Disease (NAFLD) in patients with Type 2 Diabetes Mellitus. Clinical Diabetes and Endocrinology 2016;2:9 https://doi.org/10.1186/s40842-016-0027-7
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