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In vivo, ex vivo and in vitro evidence for atropine-mediated attenuation of glucagon-like peptide-1 secretion: findings from a systematic review


Glucagon-like peptide-1 (GLP-1) is involved in postprandial glucose homeostasis. Secretion of which involves a cholinergic pathway. Anticholinergic agent like atropine could act as a competitive antagonist of acetylcholine at muscarinic receptors. This review explores studies that assess the role of atropine in GLP-1 secretion. We selected published original articles from PubMed, Science Direct, The Cochrane Library, Trip, Google and the reference lists of the selected articles. Reporting was done according to the PRISMA statement. Relevant standard and previously published tools were used to assess the risk of bias of the selected articles. Twelve articles out of 185 search results fulfilled the review criteria. Eight were in vivo studies (six animal and two human studies), three were ex vivo studies and one was an in vitro study. Animal studies had rats, mice, pigs and monkeys as the subjects. Human studies involved healthy men and women. Majority of the studies reported an atropine-mediated attenuation of GLP-1 secretion and postprandial secretion of GLP-1 was mainly affected. However, atropine failed to significantly affect GLP-1 secretion when dipeptidyl peptidase-4 (DPP-4) enzyme was inhibited.

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Animal Research: Reporting of In Vivo Experiments


Consolidated Standards of Reporting Trials


dipeptidyl peptidase-4


glucose-dependent insulinotropic peptide


glucagon-like peptide-1


Medical Subject Headings


oral glucose load


Preferred Reporting Items for Systematic Review and Meta-Analysis


secretin tumour cell


Systematic Review Centre for Laboratory Animal Experimentation


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All data generated or analysed during this review were included in this published article (and its online resource).

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DR conceived the idea, and all authors designed the review. DR performed a comprehensive literature search. DR screened the titles and abstracts of all identified studies for eligibility. The selected study was independently reviewed by SA and CJ to confirm the eligibility. DR performed the risk of bias assessment for each selected study and SA, CJ independently reviewed the assessment to confirm consistency. DR extracted the relevant data and SA, CJ independently reviewed the extracted data to confirm reliability. DR was involved in data extraction and analysis. DR drafted the manuscript and SA, CJ critically revised it. All authors read and approved the final manuscript.

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Correspondence to Devarajan Rathish.

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The title of data - Risk of bias assessment in individual studies of the systematic review on atropine mediated attenuation of glucagon-like peptide-1 secretion, 2018. Description of data - This provides the results for risk of bias assessment in individual studies of the systematic review (DOCX 20.8 kb)


Title of data - PRISMA 2009 checklist. Description of data - This provides the PRISMA 2009 checklist related to the systematic review (DOC 31.7 kb)

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Rathish, D., Agampodi, S. & Jayasumana, C. In vivo, ex vivo and in vitro evidence for atropine-mediated attenuation of glucagon-like peptide-1 secretion: findings from a systematic review. Environ Sci Pollut Res 26, 29597–29605 (2019).

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  • Atropine
  • Glucagon-like peptide-1
  • Dipeptidyl peptidase-4
  • Cholinergic pathway