The role of glucagon-like peptide-1 receptor agonists in the treatment of dyslipidemia in patients with overweight and obesity (review)

Obesity and dyslipidemia are the most important components of cardiometabolic risk, formed against the background of complex pathophysiological interactions between visceral adipose tissue, lipid and carbohydrate metabolism, as well as endocrine regulation. In this review, we present current data on the relationship between obesity and atherogenic dyslipidemia, as well as systematic information on the clinical and metabolic efficacy of glucagon-like peptide-1 (arGPP-1) receptor agonists, in particular semaglutide, in overweight, obese and associated lipid metabolism disorders. The mechanisms of action of arGPP-1 in the correction of dyslipidemia are considered, the effect on lipid profile parameters and the potential of the drug in managing the risk of cardiovascular diseases are evaluated. Data from randomized controlled trials (including SELECT, SUSTAIN, STEP, PIONEER), meta-analyses, retrospective observational studies, and experimental studies were analyzed. It should be noted that long-term use of the drug semaglutide contributes to a decrease in body weight by 10-15% over 68 weeks of therapy. Based on the presented data, a significant positive effect of the use of semaglutide in relation to the correction of lipid profile parameters was noted. The mechanisms include suppression of lipogenesis, activation of lipolysis, and slowing gastric emptying. The drug reduces the levels of atherogenic lipid fractions — triglycerides (TG) by 12-18%, low-density lipoprotein cholesterol (LDL) by 5-7% and very low-density lipoprotein cholesterol (VLDL) by 21% — both on an empty stomach and in the postprandial period. In addition, the use of arGPP-1 is associated with a 20% reduction in the risk of serious adverse cardiovascular events in patients with obesity and cardiovascular diseases. The advantage of arGPP-1 use is not only in reducing body weight, but also in correcting dyslipidemia was shown, with prospects for its use as part of comprehensive, personalized strategies for the prevention and treatment of cardiometabolic disorders.

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