GLP-1 inhibitors may protect against brain degeneration

GLP-1 inhibitors reduced the incidence of dementia, stroke and all-cause mortality in obese patients with type 2 diabetes in a study led by Taiwanese researchers.A particularly strong association was found in individuals over the age of 60; in women, who have a higher baseline risk of dementia; and in subjects with a body mass index between 30 and 40.“I think everyone agrees that if this is confirmed, it will still be a significant benefit,” commented Dr. Rémi Rabasa-Lhoret, a diabetes expert at the Montreal Clinical Research Institute.The study involved nearly 61,000 adults with obesity and type 2 diabetes. Participants were divided into two groups; one treated with a GLP-1 receptor agonist and the other with a diabetes medication.During a seven-year followup, participants treated with the GLP-1 inhibitor had a lower risk of dementia, ischemic stroke and all-cause mortality. No difference was measured in the risk of hemorrhagic stroke or Parkinson's disease.“These results suggest potential neuroprotective and cerebrovascular benefits beyond blood glucose control, warranting further trials to confirm these findings,” according to the article published in JAMA Network Open.However, it is extremely difficult to determine whether these benefits are directly attributable to the molecule or rather to the improvement in the patient's overall health; in other words, could comparable benefits have been achieved by improving the patient's health without a GLP-1 agonist?This is a question that cannot be answered at this time, said Dr. Rabasa-Lhoret, although it seems likely that the molecule plays an important role. For example, in a study conducted with patients suffering from fatty liver disease, researchers estimated that approximately half of the benefits observed were attributable to the molecule used.As a general rule, it would appear that these inhibitors act on low-level inflammation, which can cause significant damage over time, said Dr. Rabasa-Lhoret.“It may be inflammation, it may be a direct action on mechanisms,” he said. “But it may also be a combination of better blood pressure, slightly lower blood fat levels, and slightly better blood sugar levels.”The authors of the study agree. Epidemiological studies, they note, have suggested that the co-occurrence of type 2 diabetes and obesity may increase the risk of dementia through additive effects.“Systemic inflammation and oxidative stress induced by obesity, when exacerbated by insulin resistance and mitochondrial dysfunction in type 2 diabetes, can accelerate cognitive decline and the development of dementia,” they added."Studies demonstrating the benefits of various GLP-1 agonists are multiplying, and we probably haven't seen anything yet," said Dr. Rabasa-Lhoret.For example, it is known that the molecule appears to help reduce alcohol, drug and tobacco consumption. A pharmaceutical company has reportedly obtained interesting results when treating patients in the advanced stages of Alzheimer's disease. And other molecules that cause almost “alarming” weight loss are currently in development.“The problem is that it's a race to lose weight, when it should be a race to improve health,” said Dr. Rabasa-Lhoret.This article has been translated from its original French and first appeared on our sister site Profession Santé.

GLP-1 inhibitors may protect against brain degeneration

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