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. Author manuscript; available in PMC: 2015 Jul 23.
Published in final edited form as: Nat Med. 2013 May;19(5):534–536. doi: 10.1038/nm.3196

Fig. 1. Cardiometabolic actions of GLP-1 and GLP-1 agonists through activation of atrial ANP secretion.

Fig. 1

Nutrients from meals are absorbed by the ileum followed by release of GLP-1 from secretory vesicles in ileum epithelial cells. In the pancreas, GLP-1 reduces glucagon secretion and increases insulin release via GLP-1R to regulate optimal glucose homeostasis. GLP-1 activates GLP-1Rs in the atrial myocardium, which induces ANP secretion from atrial secretory granules; this action is mimicked by the long acting GLP-1 agonist liraglutide via activation of Epac2, which stimulates secretion of ANP. ANP mediates pleotropic actions via GC-A/cGMP signaling to reduce blood pressure by augmenting endothelial permeability and inducing vascular smooth muscle relaxation in the vessel wall, and enhancing sodium excretion and, inhibiting sodium ion reabsorption in the kidney. ANP may also improve metabolic homeostasis through activating lipolysis and energy utilization in adipocytes, resulting in increased energy expenditure.