Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Short Communication

Volume 13, Number 5, October 2022, pages 303-308

A Significant Effect of Oral Semaglutide on Cardiovascular Risk Factors in Patients With Type 2 Diabetes

**Table 1.** Baseline Characteristics for Patients Who Had Taken Oral Semaglutide (N = 47)
Clinical characteristics
SD: standard deviation.
Age (years old)	58.2 ± 13.5
Gender (male/female)	25/22
Body weight (mean ± SD, kg)	78.9 ± 17.7
Body mass index (mean ± SD, kg/m²)	30.5 ± 6.0
Systolic blood pressure (mean ± SD, mm Hg)	133.1 ± 14.1
Diastolic blood pressure (mean ± SD, mm Hg)	77.9 ± 10.6
Comorbidities
Dyslipidemia (n, %)	43, 91.5%
Hypertension (n, %)	30, 63.8%
Hyperuricemia (n, %)	12, 25.5%
Treatments for type 2 diabetes
Dipeptidyl peptidase-4 inhibitors (n, %)	30, 63.8%
Metformin (n, %)	35, 74.5%
Sodium-glucose cotransporter 2 inhibitors (n, %)	39, 83.0%
Sulfonylurea (n, %)	8, 17.0%
α-glucosidase inhibitors (n, %)	7, 15.0%
Pioglitazone (n, %)	17, 36.2%
Insulin (n, %)	3, 6.4%
Glucagon-like peptide 1 analogues (n, %)	11, 23.4%
Treatments for hypertension
Angiotensin receptor blockers (n, %)	28, 59.6%
Calcium antagonists (n, %)	15, 31.9%
Diuretics (n, %)	2, 4.3%
α, β-blockers (n, %)	4, 8.5%
Treatments for dyslipidemia
Statins (n, %)	31, 66.0%
Ezetimibe (n)	6, 12.8%
Eicosapentaenoic acid (n, %)	6, 12.8%
Pemafibrate (n, %)	5, 10.6%
Fenofibrate (n, %)	1, 2.1%
Treatments for hyperuricemia
Febuxostat (n, %)	3, 8.9%
Topiroxostat (n, %)	1, 3.3%
Allopurinol (n, %)	2, 4.9%
Dotinurad (n, %)	1, 3.3%

Table 1. Baseline Characteristics for Patients Who Had Taken Oral Semaglutide (N = 47)

Clinical characteristics

SD: standard deviation.

Age (years old)

58.2 ± 13.5

Gender (male/female)

25/22

Body weight (mean ± SD, kg)

78.9 ± 17.7

Body mass index (mean ± SD, kg/m²)

30.5 ± 6.0

Systolic blood pressure (mean ± SD, mm Hg)

133.1 ± 14.1

Diastolic blood pressure (mean ± SD, mm Hg)

77.9 ± 10.6

Comorbidities

Dyslipidemia (n, %)

43, 91.5%

Hypertension (n, %)

30, 63.8%

Hyperuricemia (n, %)

12, 25.5%

Treatments for type 2 diabetes

Dipeptidyl peptidase-4 inhibitors (n, %)

30, 63.8%

Metformin (n, %)

35, 74.5%

Sodium-glucose cotransporter 2 inhibitors (n, %)

39, 83.0%

Sulfonylurea (n, %)

8, 17.0%

α-glucosidase inhibitors (n, %)

7, 15.0%

Pioglitazone (n, %)

17, 36.2%

Insulin (n, %)

3, 6.4%

Glucagon-like peptide 1 analogues (n, %)

11, 23.4%

Treatments for hypertension

Angiotensin receptor blockers (n, %)

28, 59.6%

Calcium antagonists (n, %)

15, 31.9%

Diuretics (n, %)

2, 4.3%

α, β-blockers (n, %)

4, 8.5%

Treatments for dyslipidemia

Statins (n, %)

31, 66.0%

Ezetimibe (n)

6, 12.8%

Eicosapentaenoic acid (n, %)

6, 12.8%

Pemafibrate (n, %)

5, 10.6%

Fenofibrate (n, %)

1, 2.1%

Treatments for hyperuricemia

Febuxostat (n, %)

3, 8.9%

Topiroxostat (n, %)

1, 3.3%

Allopurinol (n, %)

2, 4.9%

Dotinurad (n, %)

1, 3.3%

**Table 2.** Changes in Metabolic Parameters After the Start of Oral Semaglutide in All Patients (N = 47)
	N	Baseline	After 3 months	N	Baseline	After 6 months
Values were shown as mean ± SD. P < 0.1, *P < 0.05 vs. baseline. HbA1c: hemoglobin A1c; ALT: alanine aminotransferase; AST: aspartate aminotransferase; eGFR: estimated glomerular filtration rate; GGT: gamma-glutamyl transferase; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; non-HDL-C: non-high-density lipoprotein cholesterol; TG: triglyceride; UA: uric acid; UACR: urinary albumin to creatinine ratio.
Body weight (kg)	40	78.9 ± 17.7	77.5 ± 17.9**	25	79.7 ± 19.3	77.3 ± 19.5**
Systolic blood pressure (mm Hg)	41	133.1 ± 14.1	130.1 ± 15.8	25	134.0 ± 14.7	127.8 ± 14.3**
Diastolic blood pressure (mm Hg)	41	77.9 ± 10.6	76.7 ± 11.7	25	77.9 ± 10.6	77.0 ± 12.6
Plasma glucose (mg/dL)	40	179.2 ± 96.1	170.6 ± 57.8	26	183.5 ± 116.2	162.3 ± 63.1
HbA1c (%)	41	8.1 ± 1.5	7.9 ± 1.5*	26	8.4 ± 1.5	7.8 ± 1.5**
AST (IU/L)	41	30.3 ± 17.3	29.0 ± 14.3	28	32.1 ± 19.3	31.0 ± 20.0
ALT (IU/L)	41	43.2 ± 32.5	40.4 ± 27.6	28	45.0 ± 35.0	41.0 ± 35.0
GGT (IU/L)	36	49.5 ± 43.8	45.5 ± 37.1	24	56.3 ± 51.2	53.0 ± 51.0
TG (mg/dL)	39	205.5 ± 129.2	199.0 ± 168.9	26	210.9 ± 137.5	190.2 ± 123.9
HDL-C (mg/dL)	39	52.2 ± 13.5	51.0 ± 11.5	26	50.8 ± 14,1	49.2 ± 13.1
LDL-C (mg/dL)	37	96.8 ± 28.5	92.5 ± 25.6	26	101.0 ± 31.0	91.3 ± 25.5**
Non-HDL-C (mg/dL)	36	128.3 ± 36.6	125.0 ± 36.1	24	132.0 ± 39.6	122.2 ± 31.7*
UA (mg/dL)	39	5.1 ± 1.2	4.9 ± 1.3	27	5.1 ± 1.5	5.1 ± 1.2
eGFR (mL/min/1.73 m²)	41	80.5 ± 25.3	82.5 ± 25.3	28	80.6 ± 26.8	78.7 ± 26.8
UACR	25	107.9 ± 224.9	62.5 ± 117.4*	14	123.1 ± 255.8	93.9 ± 211.8*

Table 2. Changes in Metabolic Parameters After the Start of Oral Semaglutide in All Patients (N = 47)

Baseline

After 3 months

Baseline

After 6 months

Values were shown as mean ± SD. *P < 0.1, **P < 0.05 vs. baseline. HbA1c: hemoglobin A1c; ALT: alanine aminotransferase; AST: aspartate aminotransferase; eGFR: estimated glomerular filtration rate; GGT: gamma-glutamyl transferase; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; non-HDL-C: non-high-density lipoprotein cholesterol; TG: triglyceride; UA: uric acid; UACR: urinary albumin to creatinine ratio.

Body weight (kg)

78.9 ± 17.7

77.5 ± 17.9**

79.7 ± 19.3

77.3 ± 19.5**

Systolic blood pressure (mm Hg)

133.1 ± 14.1

130.1 ± 15.8

134.0 ± 14.7

127.8 ± 14.3**

Diastolic blood pressure (mm Hg)

77.9 ± 10.6

76.7 ± 11.7

77.9 ± 10.6

77.0 ± 12.6

Plasma glucose (mg/dL)

179.2 ± 96.1

170.6 ± 57.8

183.5 ± 116.2

162.3 ± 63.1

HbA1c (%)

8.1 ± 1.5

7.9 ± 1.5*

8.4 ± 1.5

7.8 ± 1.5**

AST (IU/L)

30.3 ± 17.3

29.0 ± 14.3

32.1 ± 19.3

31.0 ± 20.0

ALT (IU/L)

43.2 ± 32.5

40.4 ± 27.6

45.0 ± 35.0

41.0 ± 35.0

GGT (IU/L)

49.5 ± 43.8

45.5 ± 37.1

56.3 ± 51.2

53.0 ± 51.0

TG (mg/dL)

205.5 ± 129.2

199.0 ± 168.9

210.9 ± 137.5

190.2 ± 123.9

HDL-C (mg/dL)

52.2 ± 13.5

51.0 ± 11.5

50.8 ± 14,1

49.2 ± 13.1

LDL-C (mg/dL)

96.8 ± 28.5

92.5 ± 25.6

101.0 ± 31.0

91.3 ± 25.5**

Non-HDL-C (mg/dL)

128.3 ± 36.6

125.0 ± 36.1

132.0 ± 39.6

122.2 ± 31.7*

UA (mg/dL)

5.1 ± 1.2

4.9 ± 1.3

5.1 ± 1.5

5.1 ± 1.2

eGFR (mL/min/1.73 m²)

80.5 ± 25.3

82.5 ± 25.3

80.6 ± 26.8

78.7 ± 26.8

UACR

107.9 ± 224.9

62.5 ± 117.4*

123.1 ± 255.8

93.9 ± 211.8*

**Table 3.** Changes in Metabolic Parameters After the Start of Oral Semaglutide in Patients Who Had not Used GLP-1 Analogues (N = 36)
	N	Baseline	After 3 months	N	Baseline	After 6 months
Values were shown as mean ± SD. P < 0.1, *P < 0.05 vs. baseline. HbA1c: hemoglobin A1c; ALT: alanine aminotransferase; AST: aspartate aminotransferase; eGFR: estimated glomerular filtration rate; GGT: gamma-glutamyl transferase; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; non-HDL-C: non-high-density lipoprotein cholesterol; TG: triglyceride; UA: uric acid; UACR: urinary albumin to creatinine ratio.
Body weight (kg)	29	77.2 ± 17.5	75.8 ± 17.8**	19	77.1 ± 17.6	75.0 ± 18.0**
Systolic blood pressure (mm Hg)	30	133.7 ± 15.7	130.3 ± 18.2	19	135.0 ± 16.0	129.3 ± 16.0**
Diastolic blood pressure (mm Hg)	30	78.9 ± 11.4	76.0 ± 11.7	19	79.5 ± 11.3	78.6 ± 13.3
Plasma glucose (mg/dL)	29	188.3 ± 109.6	171.1 ± 59.6	20	189.6 ± 130.3	166.4 ± 71.1
HbA1c (%)	30	8.3 ± 1.3	8.0 ± 1.5**	20	8.6 ± 1.5	7.9 ± 1.6**
AST (IU/L)	30	30.9 ± 19.7	29.0 ± 16.1	22	32.4 ± 21.6	30.2 ± 22.1
ALT (IU/L)	30	43.6 ± 36.6	40.1 ± 30.8	22	43.6 ± 38.3	38.5 ± 38.1
GGT (IU/L)	26	54.0 ± 49.8	49.2 ± 41.6	19	58.9 ± 56.7	53.9 ± 56.2
TG (mg/dL)	28	212.4 ± 137.9	179.3 ± 115.8*	20	218.1 ± 145.0	176.3 ± 100.6**
HDL-C (mg/dL)	28	54.0 ± 14.1	52.2 ± 11.6*	20	53.7 ± 14.4	52.1 ± 12.9
LDL-C (mg/dL)	26	100.6 ± 31.5	90.5 ± 27.6**	20	102.8 ± 33.5	90.3 ± 26.3**
Non-HDL-C (mg/dL)	26	132.8 ± 39.6	121.8 ± 35.5**	18	135.7 ± 42.9	120.1 ± 32.9**
UA (mg/dL)	28	5.0 ± 1.2	5.0 ± 1.2	21	4.9 ± 1.3	4.9 ± 1.2
eGFR (mL/min/1.73 m²)	30	81.3 ± 24.5	83.1 ± 23.7	22	79.3 ± 25.1	77.4 ± 23.1
UACR	19	101.4 ± 220.9	70.4 ± 132.6	11	148.2 ± 285.8	111.2 ± 238.1*

Table 3. Changes in Metabolic Parameters After the Start of Oral Semaglutide in Patients Who Had not Used GLP-1 Analogues (N = 36)

Baseline

After 3 months

Baseline

After 6 months

Body weight (kg)

77.2 ± 17.5

75.8 ± 17.8**

77.1 ± 17.6

75.0 ± 18.0**

Systolic blood pressure (mm Hg)

133.7 ± 15.7

130.3 ± 18.2

135.0 ± 16.0

129.3 ± 16.0**

Diastolic blood pressure (mm Hg)

78.9 ± 11.4

76.0 ± 11.7

79.5 ± 11.3

78.6 ± 13.3

Plasma glucose (mg/dL)

188.3 ± 109.6

171.1 ± 59.6

189.6 ± 130.3

166.4 ± 71.1

HbA1c (%)

8.3 ± 1.3

8.0 ± 1.5**

8.6 ± 1.5

7.9 ± 1.6**

AST (IU/L)

30.9 ± 19.7

29.0 ± 16.1

32.4 ± 21.6

30.2 ± 22.1

ALT (IU/L)

43.6 ± 36.6

40.1 ± 30.8

43.6 ± 38.3

38.5 ± 38.1

GGT (IU/L)

54.0 ± 49.8

49.2 ± 41.6

58.9 ± 56.7

53.9 ± 56.2

TG (mg/dL)

212.4 ± 137.9

179.3 ± 115.8*

218.1 ± 145.0

176.3 ± 100.6**

HDL-C (mg/dL)

54.0 ± 14.1

52.2 ± 11.6*

53.7 ± 14.4

52.1 ± 12.9

LDL-C (mg/dL)

100.6 ± 31.5

90.5 ± 27.6**

102.8 ± 33.5

90.3 ± 26.3**

Non-HDL-C (mg/dL)

132.8 ± 39.6

121.8 ± 35.5**

135.7 ± 42.9

120.1 ± 32.9**

UA (mg/dL)

5.0 ± 1.2

4.9 ± 1.3

4.9 ± 1.2

eGFR (mL/min/1.73 m²)

81.3 ± 24.5

83.1 ± 23.7

79.3 ± 25.1

77.4 ± 23.1

UACR

101.4 ± 220.9

70.4 ± 132.6

148.2 ± 285.8

111.2 ± 238.1*

**Table 4.** Changes in Metabolic Parameters After the Start of Oral Semaglutide in Patients Who Switched From Other GLP-1 Analogues (N = 11)
	N	Baseline	after 3 months	N	Baseline	after 6 months
Values were shown as mean ± SD. P < 0.1, *P < 0.05 vs. baseline. GLP-1: glucagon-like peptide 1; HbA1c: hemoglobin A1c; ALT: alanine aminotransferase; AST: aspartate aminotransferase; eGFR: estimated glomerular filtration rate; GGT: gamma-glutamyl transferase; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; non-HDL-C: non-high-density lipoprotein cholesterol; TG: triglyceride; UA: uric acid; UACR: urinary albumin to creatinine ratio.
Body weight (kg)	11	83.5 ± 18.0	81.8 ± 18.4	6	87.8 ± 24.0	84.8 ± 23.7**
Systolic blood pressure (mm Hg)	11	131.5 ± 8.9	129.5 ± 6.4	6	131.0 ± 5.5	123.0 ± 9.2
Diastolic blood pressure (mm Hg)	11	75.1 ± 9.3	78.5 ± 12.0*	6	78.7 ± 10.9	71.8 ± 9.2
Plasma glucose (mg/dL)	11	155.4 ± 39.0	169.3 ± 55.5	6	163.5 ± 49.3	148.7 ± 21.4
HbA1c (%)	11	7.6 ± 1.3	7.8 ± 1.3	6	7.8 ± 1.5	7.6 ± 1.2
AST (IU/L)	11	28.5 ± 7.4	28.7 ± 7.8	6	31.2 ± 7.0	34.2 ± 9.9
ALT (IU/L)	11	42.1 ± 18.6	41.4 ± 16.9	6	50.0 ± 20.1	50.3 ± 18.7
GGT (IU/L)	10	37.6 ± 18.6	35.9 ± 20.4	5	46.2 ± 20.7	49.8 ± 27.1
TG (mg/dL)	11	187.7 ± 107.8	249.2 ± 261.5	6	187.2 ± 117.5	236.8 ± 186.8
HDL-C (mg/dL)	11	47.6 ± 11.1	48.0 ± 11.2	6	41.2 ± 7.5	39.5 ± 8.8
LDL-C (mg/dL)	11	89.2 ± 19.0	97.3 ± 20.3*	6	94.8 ± 21.5	95.0 ± 24.6
Non-HDL-C (mg/dL)	10	116.8 ± 25.4	133.5 ± 38.1**	6	121.0 ± 27.6	129.2 ± 29.7
UA (mg/dL)	11	5.1 ± 1.6	4.8 ± 1.6**	6	5.8 ± 1.8	5.6 ± 1.5
eGFR (mL/min/1.73 m²)	11	78.3 ± 28.5	80.7 ± 30.5	6	85.3 ± 34.7	83.3 ± 40.7
UACR	6	128.5 ± 257.5	37.4 ± 43.9	3	31.4 ± 27.5	30.4 ± 18.6

Table 4. Changes in Metabolic Parameters After the Start of Oral Semaglutide in Patients Who Switched From Other GLP-1 Analogues (N = 11)

Baseline

after 3 months

Baseline

after 6 months

Values were shown as mean ± SD. *P < 0.1, **P < 0.05 vs. baseline. GLP-1: glucagon-like peptide 1; HbA1c: hemoglobin A1c; ALT: alanine aminotransferase; AST: aspartate aminotransferase; eGFR: estimated glomerular filtration rate; GGT: gamma-glutamyl transferase; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; non-HDL-C: non-high-density lipoprotein cholesterol; TG: triglyceride; UA: uric acid; UACR: urinary albumin to creatinine ratio.

Body weight (kg)

83.5 ± 18.0

81.8 ± 18.4

87.8 ± 24.0

84.8 ± 23.7**

Systolic blood pressure (mm Hg)

131.5 ± 8.9

129.5 ± 6.4

131.0 ± 5.5

123.0 ± 9.2

Diastolic blood pressure (mm Hg)

75.1 ± 9.3

78.5 ± 12.0*

78.7 ± 10.9

71.8 ± 9.2

Plasma glucose (mg/dL)

155.4 ± 39.0

169.3 ± 55.5

163.5 ± 49.3

148.7 ± 21.4

HbA1c (%)

7.6 ± 1.3

7.8 ± 1.3

7.8 ± 1.5

7.6 ± 1.2

AST (IU/L)

28.5 ± 7.4

28.7 ± 7.8

31.2 ± 7.0

34.2 ± 9.9

ALT (IU/L)

42.1 ± 18.6

41.4 ± 16.9

50.0 ± 20.1

50.3 ± 18.7

GGT (IU/L)

37.6 ± 18.6

35.9 ± 20.4

46.2 ± 20.7

49.8 ± 27.1

TG (mg/dL)

187.7 ± 107.8

249.2 ± 261.5

187.2 ± 117.5

236.8 ± 186.8

HDL-C (mg/dL)

47.6 ± 11.1

48.0 ± 11.2

41.2 ± 7.5

39.5 ± 8.8

LDL-C (mg/dL)

89.2 ± 19.0

97.3 ± 20.3*

94.8 ± 21.5

95.0 ± 24.6

Non-HDL-C (mg/dL)

116.8 ± 25.4

133.5 ± 38.1**

121.0 ± 27.6

129.2 ± 29.7

UA (mg/dL)

5.1 ± 1.6

4.8 ± 1.6**

5.8 ± 1.8

5.6 ± 1.5

eGFR (mL/min/1.73 m²)

78.3 ± 28.5

80.7 ± 30.5

85.3 ± 34.7

83.3 ± 40.7

UACR

128.5 ± 257.5

37.4 ± 43.9

31.4 ± 27.5

30.4 ± 18.6