Exenatide improves cardiovascular risk factors in obese patients with type 2 diabetes mellitus: a prospective study

Abstract

Background/aim: The aim of this study was to evaluate the effects of 6-months treatment with exenatide on lipid profile, high sensitivity C-reactive protein (hsCRP), carotid intima media thickness (CIMT), visceral adiposity and non-alcoholic fatty liver disease (NAFLD), which are all important cardiovascular risk factors. Materials and methods: This study included 45 obese patients with type 2 diabetes mellitus (T2DM). The baseline clinical findings, laboratory parameters and ultrasonography findings were recorded. Exenatide twice daily recipe was given to these patients and after 6 months of therapy the same variables were compared. The compared parameters were lipid profiles, hsCRP, aspartat aminotransferase, alanine aminotransferase, gamma-glutamyltransferase, liver craniocaudal diameter, visceral fat volume, subcutaneous fat thickness and CIMT. Liver diameter, visceral fat volume and subcutaneous fat thickness and CIMT were measured with ultrasonography. Results: After therapy, statistically significant improvement were achieved in lipid profile, hsCRP, liver enzymes, body mass index, waist and hip circumferences. Also statistically significant decrease were obtained in liver craniocaudal diameter, subcutaneous fat thickness, visceral fat volume and CIMT. The reduction of CIMT and liver diameter were not correlated with BMI and HbA1c reduction. Conclusion: This study showed improvement in lipid profile and hsCRP levels with exenatide treatment. We also showed decrease in both visceral fat volume and subcutaneous fat thickness. We demonstrated significant decrease in liver enzymes with 2 significant decrease in liver diameter. These findings supports the use of exenatide in patients with NAFLD and T2DM. Additionally this study showed that twice daily exenatide treatment reduces CIMT in obese T2DM patients.

Effects of Glucagon-Like Peptide-1 Receptor Agonists and Sodium-Glucose Cotransporter 2 Inhibitors on Intima-Media Thickness: Systematic Review and Meta-Analysis

“…The literature search yielded 708 related articles after duplicates were removed. Eighteen studies examined the effects of GLP-1 RA [11][12][13][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31], and eleven examined the effects of SGLT2i on IMT [32][33][34][35][36][37][38][39][40][41][42]. Studies that did not provide IMT results [43][44][45][46][47][48][49], duplicate data [50][51][52][53][54][55][56], combination therapies without apparent GLP-1 RA effects [57], or assessed IMT of arteries other than the carotid artery were excluded [58][59][60].…”

“…Characteristics of the Included Studies. Three different GLP-1 RA drugs were investigated in the included studies: liraglutide [11,12,16,18,[23][24][25][26][27][28][29], semaglutide [21], and exenatide [19,22,30,31]. Also, five different SGLT2i drugs were studied, including empagliflozin [32,36,38,42], ipragliflozin [33,39,41], tofogliflozin [34,40], dapagliflozin [35][36][37]42], and luseogliflozin [40].…”

“…The range of intervention periods for GLP-1 RA trials ranged from 4 months [12,13,21,26] to 3 years [29] and for SGLT2i trials was from 2 weeks [38] to 3.6 years [36]. All SGLT2i studies [32][33][34][35][36][37][38][39][40][41][42] and fifteen GLP-1 RA studies included T2DM patients [11,12,17,[19][20][21][22][23][24][25][26][27][29][30][31]. Italy (n = 7) was the country with the largest number of published articles for GLP-1 RA and Japan for SGLT2i (n = 5).…”

Primordial Drivers of Diabetes Heart Disease: Comprehensive Insights into Insulin Resistance

“…However, edema is a potential side effect and should be used with caution in subjects at risk for HF, and the degree of edema should be monitored regularly. Exenatide, a glucagon-like peptide 1 receptor (GLP-1R) agonist, improves calcium circulation, cardiac systolic function and endothelial function, and has the potential to treat T2DM combined with HF [ 106 , 107 ]. However, this class of drugs may directly affect sinus node myocytes and enhance sympathetic nervous system activity, and the therapeutic effect in HF clinical treatment is unstable.…”