[Glucagon-like peptide-1: pleiotropic effects on the cardiovascular system]

The glucagon-like peptide-1 (GLP-1) is a 30-amino acid peptide hormone produced in the intestinal epithelial endocrine L-cells in response to meal intake. Once secreted it is readily inactivated by the enzyme dipeptidyl peptidase 4. The main actions of GLP-1 are: 1) to stimulate insulin secretion; 2) to inhibit glucagon secretion; 3) to slow gastric emptying; 4) to stimulate the neogenesis of insulin secreting cells. Type 2 diabetic patients have a reduced GLP-1 secretion in response to meal intake: for this reason the use of incretin mimetic drugs may be useful in these patients. These compounds may decrease glycated hemoglobin of roughly 1% compared to placebo treatment. GLP-1 exerts also important extra pancreatic effects. It is known to affect the cardiovascular system by decreasing blood pressure, to improve the endothelial function, and to increase myocardial contractility. Such effects are discussed in depth in this article.