The Effect of Exenatide on Thyroid-Stimulating Hormone and Thyroid Volume

Sencar, Muhammed Erkam; Sakız, Davut; Çalapkulu, Murat; Hepşen, Sema; Kızılgül, Muhammed; Ozturk, Ilknur Unsal; Uçan, Bekir; Bayram, Murat; Çağır, Büşra Betül; Akın, Şafak; Özbek, Mustafa

doi:10.1159/000501895

Cited by 10 publications

(21 citation statements)

References 31 publications

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“…GLP-1 stimulates type 3 iodothyronine deiodinase (D3) expression through the GLP-1 receptor, and the regulation of intracellular (T3) concentration by D3 may be involved in the stimulation of insulin secretion by GLP-1 ( 75 ). In addition, a clinical study showed that exenatide treatment for 6 months significantly reduced the serum TSH concentration in diabetic patients without thyroid disease ( 76 ). In conclusion, some animal studies have provided evidence that the use of GLP-1 receptor agonists increases the risk of thyroid disease, but this evidence has not been confirmed in humans.…”

Section: Discussionmentioning

confidence: 99%

Use of GLP-1 Receptor Agonists and Occurrence of Thyroid Disorders: a Meta-Analysis of Randomized Controlled Trials

Song

Cheng

et al. 2022

Front. Endocrinol.

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The association between glucagon-like peptide-1 (GLP-1) receptor agonists and the risk of various kinds of thyroid disorders remains uncertain. We aimed to evaluate the relationship between the use of GLP-1 receptor agonists and the occurrence of 6 kinds of thyroid disorders. We searched PubMed (MEDLINE), EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science from database inception to 31 October 2021 to identify eligible randomized controlled trials (RCTs). We performed meta-analysis using a random-effects model to calculate risk ratios (RRs) and 95% confidence intervals (CIs). A total of 45 trials were included in the meta-analysis. Compared with placebo or other interventions, GLP-1 receptor agonists’ use showed an association with an increased risk of overall thyroid disorders (RR 1.28, 95% CI 1.03-1.60). However, GLP-1 receptor agonists had no significant effects on the occurrence of thyroid cancer (RR 1.30, 95% CI 0.86-1.97), hyperthyroidism (RR 1.19, 95% CI 0.61-2.35), hypothyroidism (RR 1.22, 95% CI 0.80-1.87), thyroiditis (RR 1.83, 95% CI 0.51-6.57), thyroid mass (RR 1.17, 95% CI 0.43-3.20), and goiter (RR 1.17, 95% CI 0.74-1.86). Subgroup analyses and meta-regression analyses showed that underlying diseases, type of control, and trial durations were not related to the effect of GLP-1 receptor agonists on overall thyroid disorders (all P subgroup > 0.05). In conclusion, GLP-1 receptor agonists did not increase or decrease the risk of thyroid cancer, hyperthyroidism, hypothyroidism, thyroiditis, thyroid mass and goiter. However, due to the low incidence of these diseases, these findings need to be examined further.Systematic Review RegistrationPROSPERO https://www.crd.york.ac.uk/prospero/, identifier: CRD42021289121.

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Section: Discussionmentioning

confidence: 99%

Use of GLP-1 Receptor Agonists and Occurrence of Thyroid Disorders: a Meta-Analysis of Randomized Controlled Trials

Song

Cheng

et al. 2022

Front. Endocrinol.

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“…Our study also showed a significant decrease in serum TSH in liraglutide group as compared to diabetic control group. The possible mechanism could be that it may increase the sensitivity of the hypothalamus or the pituitary gland to the thyroid hormone negative feedback or else increase the number of receptors on the hypothalamus or pituitary gland [33].…”

Section: Discussionmentioning

confidence: 99%

The vascular impact of dapagliflozin, liraglutide, and atorvastatin alone or in combinations in type 2 diabetic rat model

Medany

Hammadi

Khalifa

et al. 2022

Fundamemntal Clinical Pharma

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Diabetic dyslipidemia is a significant contributor in the pathogenesis of type 2 diabetes (T2D). The study aimed at comparing the effect of dapagliflozin, liraglutide, and atorvastatin alone or their combinations on lipids and inflammatory markers and their vascular impact in T2D rats. There were 56 male albino rats included in the study and divided into two main groups. Group A (8 rats) served as normal control. Group B (48 rats) were streptozotocin-nicotinamide-induced diabetic rats. Subgroups (B-1, B-2, B-3, B-4, B-5, and B-6) received (no medications, dapagliflozin, liraglutide, atorvastatin, dapagliflozin + atorvastatin, and liraglutide + atorvastatin), respectively. Urine albumin/creatinine ratio (UACR), glycosylated hemoglobin (HBA1c), fasting serum glucose (FSG), serum low-density lipoproteincholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), TGs, lipoprotein(a) Lp (a), serum thyrotropin (TSH), highly sensitive C-reactive protein (hs-CRP) and advanced glycation end products (AGEs), were assessed. Qualitative and quantitative histological examination of kidneys focused on renal corpuscles. Dapagliflozin improved the studied parameters but with statistically insignificant increase in LDL-C, Lp (a) and significant increase in UACR. Atorvastatin improved the studied parameters but with statistically insignificant increase in FSG and HbA1C. Liraglutide and the combination groups significantly improved all studied parameters. Histologically, liraglutide and atorvastatin produced therapeutic effect, while dapagliflozin depicted nephrotoxic effect. Combination groups resulted in better effects with normalization of most of renal corpuscles. There were positive correlations between LDL-C and hs-CRP, AGEs, TSH and mesangial expansion. Combination of atorvastatin with liraglutide can improve its vasculoprotective effect. Moreover, combination of atorvastatin with dapagliflozin can ameliorate its possible nephrotoxic effect.

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“…Prolonged use of liraglutide at very high doses did not produce C-cell proliferation in monkeys and did not induce significant calcitonin level changes in human clinical studies [ 124 , 125 ]. Exenatide also did not increase calcitonin in follow-up [ 126 ]. Similarly, in the Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes (LEADER) Trial, liraglutide did not increase calcitonin or cause C-cell malignancies [ 127 ].…”

Section: Antidiabetic Agents and Thyroid Disordersmentioning

confidence: 99%

“…The GLP-1R agonist, exenatide, decreased TSH concentrations in diabetics after 6 months. Levels remained in the detectable range, and there were no significant changes in free T4, free T3, or thyroid volume [ 126 ]. A small study reported that diabetics followed for over three years taking a DPP4 inhibitor compared to diabetics on alternative therapy had higher TSH concentrations.…”

Section: Antidiabetic Agents and Thyroid Disordersmentioning

confidence: 99%

Links between Thyroid Disorders and Glucose Homeostasis

2022

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Thyroid disorders and diabetes mellitus often coexist and are closely related. Several studies have shown a higher prevalence of thyroid disorders in patients with diabetes mellitus and vice versa. Thyroid hormone affects glucose homeostasis by impacting pancreatic β-cell development and glucose metabolism through several organs such as the liver, gastrointestinal tract, pancreas, adipose tissue, skeletal muscles, and the central nervous system. The present review discusses the effect of thyroid hormone on glucose homeostasis. We also review the relationship between thyroid disease and diabetes mellitus: type 1, type 2, and gestational diabetes, as well as guidelines for screening thyroid function with each disorder. Finally, we provide an overview of the effects of antidiabetic drugs on thyroid hormone and thyroid disorders.

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The Effect of Exenatide on Thyroid-Stimulating Hormone and Thyroid Volume

Cited by 10 publications

References 31 publications

Use of GLP-1 Receptor Agonists and Occurrence of Thyroid Disorders: a Meta-Analysis of Randomized Controlled Trials

Use of GLP-1 Receptor Agonists and Occurrence of Thyroid Disorders: a Meta-Analysis of Randomized Controlled Trials

The vascular impact of dapagliflozin, liraglutide, and atorvastatin alone or in combinations in type 2 diabetic rat model

Links between Thyroid Disorders and Glucose Homeostasis

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