Journal of Shanghai Jiao Tong University (Medical Science) ›› 2026, Vol. 46 ›› Issue (5): 680-687.doi: 10.3969/j.issn.1674-8115.2026.05.015

• Review • Previous Articles    

Progress in the mechanism of the effects of antihyperglycemic agents on lipid metabolism

Wang Li1, Song Kang2()   

  1. 1.Clinical Medical College, Qinghai University, Xining 810001, China
    2.Second Ward of Endocrinology Department, Qinghai Provincial People's Hospital, Xining 810007, China
  • Received:2025-04-05 Accepted:2025-10-10 Online:2026-05-15 Published:2026-05-15
  • Contact: Song Kang E-mail:657133517@qq.com
  • Supported by:
    General Guiding Topic of Qinghai Provincial Health Commission in 2022(2022-wjzdx-04);Leading Talent of “Kunlun Talent·High-end Innovative and Entrepreneurial Talent” in Qinghai Province

Abstract:

Antihyperglycemic agents include biguanides, α-glucosidase inhibitors (AGIs), thiazolidinediones (TZDs), insulin, dipeptidyl peptidase-Ⅳ (DPP-4) inhibitors, sodium-glucose cotransporter 2 (SGLT-2) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), glucokinase activators (GKAs) and peroxisome proliferator-activated receptor (PPAR) pan-agonists. Among them, the former four categories are traditional antihyperglycemic agents, while the latter five are novel antihyperglycemic agents. Studies have demonstrated that these agents not only exert effective glucose-lowering effects, but also exhibit potential in improving lipid metabolism, although their precise mechanisms remain to be further elucidated. Long-term chronic hyperglycemia in patients with type 2 diabetes mellitus (T2DM) disrupts lipid metabolic homeostasis via multiple pathophysiological pathways. Therefore, correcting lipid metabolism disorders has become one of the key objectives of T2DM management. However, in patients with T2DM complicated by lipid metabolism disorders, it is difficult to accurately select appropriate antihyperglycemic agents for treatment at the early stage of the disease. Based on this, this article reviews recent progress in the mechanism of the effects of different antihyperglycemic agents on lipid metabolism, and further explores their effects on lipid metabolism, so as to provide a reference for clinicians in selecting antihyperglycemic agents and help T2DM patients with lipid metabolism disorders achieve long-term clinical benefits.

Key words: antihyperglycemic agent, type 2 diabetes mellitus (T2DM), lipid metabolism

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