# Semaglutide verbetert enkele endotheelmarkers bij diabetes type 2 — post-hoc analyse

*geplaatst 2026-09-16 · Hartfalen · Journal of diabetes and its complications · doi 10.1016/j.jdiacomp.2026.109397 · https://hartvaat.nl/2026/10/01/semaglutide-verbetert-enkele-endotheelmarkers-bij-diabetes-type-2-post-hoc-analy/*

Een post-hoc analyse van een gerandomiseerde studie bij 120 patiënten met diabetes type 2 onderzocht het effect van semaglutide en empagliflozin op endotheelfunctie en adhesiemoleculen. Semaglutide verbeterde de reactieve hyperemie-index ten opzichte van baseline, maar niet significant ten opzichte van placebo, waarschijnlijk door een beperkte steekproefgrootte. Wel daalde E-selectine significant in de semaglutide-groep, terwijl VCAM-1 juist steeg. De heterogene respons op endotheelmarkers suggereert dat de cardiovasculaire voordelen van GLP-1-receptoragonisten niet eenduidig via endotheelverbetering worden gemedieerd.

## English: Effects of semaglutide and empagliflozin on markers of endothelial function in persons with type 2 diabetes: A post hoc analysis of a randomized clinical trial.

A post-hoc analysis of a 32-week randomized trial in 120 patients with type 2 diabetes evaluated the effects of semaglutide and empagliflozin on endothelial function and cell adhesion molecules. Semaglutide improved reactive hyperaemia index versus baseline but not versus placebo, likely due to limited power, though E-selectin decreased significantly. Conversely, VCAM-1 levels increased with semaglutide, indicating a heterogeneous impact on endothelial markers. These findings suggest that the cardiovascular benefits of GLP-1 receptor agonists may not be uniformly mediated through endothelial pathway modulation.

## Abstract (original, from the publication)

AIMS: The endothelium maintains vascular health by regulating blood flow and protecting against inflammatory damage. In type 2 diabetes (T2DM), however, hyperglycemia, hypertension, and hyperlipidemia place a significant burden on the endothelium, potentially leading to atherosclerosis and cardiovascular disease (CVD). While semaglutide and empagliflozin have been shown to reduce CVD risk in T2DM, it remains unclear whether these benefits are mediated by improved endothelial function. This post-hoc analysis explores the effects of these agents on markers of endothelial function, i.e. the reactive hyperaemic index (RHI) and the endothelial-derived cell adhesion molecules (CAMs) E-Selectin, ICAM-1, P-Selectin, and VCAM-1. METHODS: This was a post-hoc analysis of a 32-week randomized trial evaluating the separate and combined effects of semaglutide and empagliflozin on cardio-renal organ damage. One hundred and twenty participants with type 2 diabetes, age ≥ 50 were randomized to four groups (semaglutide, empagliflozin, the combination or placebo). An increase in RHI and/or a decrease in CAMs were considered beneficial. RESULTS: RHI increased compared to baseline (0.11, 95%CI [0.008;0.21], p = 0.03) but not compared to placebo in the semaglutide group (0.11, 95%CI [-0.04;0.24], p = 0.16). There was no effect on RHI in the empagliflozin group. Compared to placebo, E-Selectin decreased significantly in the semaglutide and combination groups (-9, 95%CI [-14.1;-5.1] p < 0.01 and - 9, 95%CI [-14.3; -5.2] p < 0.01, respectively). VCAM-1 increased in the same groups, compared to placebo (12.3, 95%CI[2.8;20.8] p = 0.01 and 16.2, 95%CI [7.2;24.3], p < 0.01, respectively).P-Selectin and ICAM-1 was not significantly affected in any of the groups, compared to placebo (p ≥ 0.11 and p ≥ 0.09, respectively). CONCLUSION: Semaglutide improved endothelial function compared to baseline, but not significantly versus placebo, which likely is due to limited power. CAM responses were heterogeneous, suggesting distinct roles in endothelial dysfunction and atherosclerosis. ClinicalTrialsRegister.eu: EudraCT 2019-000781-38.

Auteurs: Søren Gullaksen, Liv Vernstrøm, Steffen Skovgaard Sørensen, Kristian Løkke Funck, Per Løgstrup Poulsen, Esben Laugesen

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Bron: Journal of diabetes and its complications, https://doi.org/10.1016/j.jdiacomp.2026.109397. Bijgewerkt 2026-09-10T01:00:32Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.