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Review
. 2010 Feb;26(2):87-95.
doi: 10.1016/s0828-282x(10)70010-6.

The incretin system and cardiometabolic disease

Paul E Szmitko  1 , Lawrence A Leiter, Subodh Verma
Affiliations
Review

The incretin system and cardiometabolic disease

Paul E Szmitko et al. Can J Cardiol. 2010 Feb.

Abstract
in English, French

Rates of type 2 diabetes, obesity and their associated detrimental cardiovascular effects are rapidly increasing. Despite the availability of several treatment options for type 2 diabetes and the use of intensive regimens combining several antidiabetic drugs, less than one-half of all patients reach a target glycosylated hemoglobin level of less than 7%. Disease progression due to ongoing deterioration of pancreatic islet cell health and beta-cell function is likely responsible. Therefore, there is a need to identify new pharmacological compounds that may not only treat hyperglycemia, but may also correct impaired glucose homeostasis and preserve endogenous beta-cell function. Identification and characterization of the incretin system and its effect on glucose homeostasis have resulted in the development of new antidiabetic agents that target these concerns. The current review examines the incretin effect and the pharmacological agents that have been developed based on the understanding of this physiological system. The influence of incretins on the cardiovascular system beyond the proatherogenic effect of type 2 diabetes will also be discussed.

On assiste à une augmentation rapide des taux de diabète de type 2 et d’obésité, ainsi que de leurs effets cardiovasculaires néfastes. Malgré les nombreuses options thérapeutiques offertes pour lutter contre le diabète de type 2 et l’utilisation de schémas intensifs alliant plusieurs agents antidiabétiques, moins de la moitié de tous les patients atteignent le taux d’hémoglobine glyquée ciblé, soit moins de 7 %. La maladie progresse probablement en raison d’une détérioration graduelle des cellules des îlots de Langerhans et du dysfonctionnement des cellules bêta. C’est pourquoi il faut tenter de mettre au point de nouveaux agents pharmacologiques qui, non seulement traiteraient l’hyperglycémie, mais corrigeraient aussi l’homéostasie anormale du glucose tout en préservant le fonctionnement des cellules bêta endogènes. La reconnaissance et la caractérisation du système des incrétines et de ses effets sur l’homéostasie du glucose ont mené au développement de nouveaux antidiabétiques qui ciblent ces aspects. La présente synthèse analyse l’effet des incrétines et des agents pharmacologiques mis au point grâce à l’approfondissement des connaissances sur ce système physiologique. On abordera en outre l’influence des incrétines sur l’appareil cardiovasculaire, au-delà de l’effet proathérogène du diabète de type 2.

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References

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