News in brief: GLP-1 RAs may have antiplatelet effects; Bone health link to bipolar disorder; More specialists are using My Health Record

12 Apr 2022

GLP-1 RAs may have antiplatelet effects

GLP-1 receptor agonists such as liraglutide may have antiplatelet effects that account for their cardiovascular benefits, according to Victorian researchers.

A study of the antiplatelet effects of liraglutide in 16 patients with type 2 diabetes found that when taking an average dose of 1.8 mg/day  for 6 months, showed a significant, early and transient decrease in maximum slope of platelet aggregation in response to collagen, arachidonic acid and ADP.

The effect was seen within the first week and was seen with the lowest dose, the researchers from Monash University reported in the Journal of Diabetes and Its Complications.

The biological mechanisms responsible for the liraglutide-mediated attenuation of platelet aggregation were unknown but might be related to a direct effect on GLP-1 receptors on platelets or a non-GLP-1R-mediated nitrous oxide (NO)-generating mechanism previously suggested for the GLP-1R agonist exenatide, they said.


Bone health link to bipolar disorder

Bipolar disorder is associated with low bone quantity and quality in women, findings from the Geelong Osteoporosis Study suggests.

A case control study involving 117 participants with bipolar disorder found that their adjusted mean BMD was 4.3% lower at the hip and 1.6% lower at the total body compared to a matched control group.

BMD of the spine was also 3.5% lower for women under 50 with bipolar disorder. People with bipolar also showed lower levels of bone quality ultrasound measures such as SOS, BUA and SI compared to controls, respectively.

The study investigators from Deakin University noted that bipolar disorder-related biomarkers, such as cortisol, oxidative stress and inflammatory cytokines are also dysregulated in bone loss, and are possible mechanistic links. Bipolar disorder treatments such as antidepressants, antipsychotics and anticonvulsants have all been shown to be independently detrimental to BMD and increase fracture risk and thus could explain some of the observed bone deficits, they added.

Lifestyle factors such as smoking, physical inactivity and excessive alcohol consumption could also be contributing factors to poor bone health they said

“Taken together, these findings indicate that women with bipolar disorder are more likely to have poorer bone health,” the authors wrote in Journal of Affective Disorders.


More specialists are using My Health Record

Use of My Health Record by specialists has increased since it became accessible through clinical software in late 2021, according to the Australian Digital Health Agency.

Its latest figures for February 2022 show that 20% of specialists have registered for the MHR and 9% have used it. In comparison 95% of public hospitals and 98% of GPs have used the MHR. While the specialist usage levels are still low, they increased by 17% in January 2022, the Agency says, and the number of documents uploaded by specialists and viewed by other healthcare providers increased by 23%.

Public hospital viewing of MHR had doubled in the last year, it noted.

The Agency said the increase likely reflects the increasing proportion of clinical software products that are compatible with the MHR and have the discharge summaries and reports for diagnostic imaging and pathology.

Ongoing funding for the Agency was confirmed in the 2022 Budget, which noted total expenditure of almost $380 million for 2021–2022. The Agency was given a target of increasing provider use of the MHR by 15% a year and a 20% increase in e-prescribing.

 

 

 

 

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