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Cited by 14Diabetes Treatment and ManagementChronic Kidney Disease and DiabetesAdipokines, Inflammation, and Metabolic Diseases

Effects of exenatide on urinary albumin in overweight/obese patients with T2DM: a randomized clinical trial

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Kang, Chao, Qiao, Qiao, Tong, Qiang, Bai, Qian, Huang, Chen, Fan, Rong, Wang, Hui, Kaliannan, Kanakaraju +2 more·2021·Scientific Reports
DOI 10.1038/s41598-021-99527-yPMC PMC8501012
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Abstract

In this study, we investigated the effect of exenatide (EXE), a glucagon-like peptide (GLP)-1 receptor agonist, on kidney function, obesity indices, and glucose control in overweight/obese patients with type 2 diabetes mellitus (T2DM). A total of 159 overweight/obese patients with T2DM were randomized to the EXE group or insulin glargine (GLAR) control group for a total treatment period of 24 weeks. EXE intervention significantly reduced the urine albumin concentration (UAC) at week 12 and 24 endpoints (P < 0.001 at week 12 and 24). The levels of the anthropometric, glucose and lipid parameters (TG and HDL-c), and inflammation biomarkers (CRP and TNF-α) in the EXE group were improved at 12 weeks or 24 weeks, respectively. Meanwhile, a comparison between two groups showed significant changes in anthropometric parameters, glucose parameters, lipid parameters (TG and HDL-c), and Inflammation biomarkers (CRP, IL-6, and TNF-α). Serum fibroblast growth factor 21 (FGF21) was increased in the EXE group (P = 0.005) at week 24, and the change was significantly improved compared with GLAR group (P = 0.003). Correlation network analysis showed that FGF21 had a more central role in improving metabolism in the EXE group, and the change of FGF 21 was significantly negatively correlated with UAC at week 12 and week 24, respectively (r = - 0.297, P = 0.010; r = - 0.294, P = 0.012). Our results showed that EXE could help patients improve UAC, glycemic levels, and inflammatory biomarkers after a follow-up period of 24 weeks intervention. These EXE effects may be partly mediated by FGF 21, indicating that EXE is an effective and safe way to control albuminuria in overweight/obese patients with T2DM.

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  • Insulin therapy is associated with weight gain.

    “insulin therapy, though essential, has rarely demonstrated superior efficacy in lowering inflammatory markers like TNF-α and CRP compared to other treatments and is associated with weight gain (14, 15).”

    From Inflammatory biomarker response to GLP-1 receptor agonists versus other glucose-lowering medications in patients with type 2 diabetes: a systematic review and meta-analysis (2026) · cites this paper as [15]

    Table 2 in Results > Other efficacy variables (page unavailable) reports a mean weight change of −0.658 kg at week 24 in the insulin glargine group, not weight gain; the change was not statistically significant (P = 0.221). This trial therefore does not show the weight gain attributed to insulin therapy, although its result does not settle whether insulin therapy is associated with weight gain more generally. (LLM, conf=0.84)

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  • Insulin therapy has rarely demonstrated superior efficacy in lowering inflammatory markers like TNF-alpha and CRP compared to other treatments.

    “insulin therapy, though essential, has rarely demonstrated superior efficacy in lowering inflammatory markers like TNF-α and CRP compared to other treatments and is associated with weight gain (14, 15).”

    From Inflammatory biomarker response to GLP-1 receptor agonists versus other glucose-lowering medications in patients with type 2 diabetes: a systematic review and meta-analysis (2026) · cites this paper as [15]

    The Study design section identifies insulin glargine as the comparator, and Results > Other efficacy variables reports significantly greater changes in CRP and TNF-α with exenatide in this 24-week trial. One comparison does not establish that insulin therapy has *rarely* shown superior efficacy across other treatments; no page number is available in our copy. (LLM, conf=0.86)

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  • Individual randomized controlled trial findings on the effects of GLP-1 receptor agonists on inflammatory biomarkers are inconsistent.

    “The findings, however, have been inconsistent. Some studies report significant reductions in TNF-α and CRP with GLP-1 RA therapy compared to placebo or other antidiabetic medications (6, 15, 17, 18), while others show non-significant or conflicting results (19, 20).”

    From Inflammatory biomarker response to GLP-1 receptor agonists versus other glucose-lowering medications in patients with type 2 diabetes: a systematic review and meta-analysis (2026) · cites this paper as [15]

    In Results > Other efficacy variables (page unavailable), the trial reports significant between-group differences in CRP and TNF-α with exenatide versus insulin glargine; its table also shows nonsignificant findings for some other inflammatory markers. This trial therefore contributes biomarker findings, but it does not establish the citing sentence’s broader claim that findings across randomized trials are inconsistent. (LLM, conf=0.82)

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  • In this study, several studies found that improvements in inflammatory markers were accompanied by decreases in albuminuria.

    “In our study, several studies found that improvements in inflammatory markers were accompanied by decreases in albuminuria (6, 15, 17, 18).”

    From Inflammatory biomarker response to GLP-1 receptor agonists versus other glucose-lowering medications in patients with type 2 diabetes: a systematic review and meta-analysis (2026) · cites this paper as [15]

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Cites

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Research works printed but not linked: 27

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Authors
Kang, C., Qiao, Q., Tong, Q., Bai, Q., Huang, C., Fan, R., Wang, H., Kaliannan, K., Wang, J., & Xu, J.
Affiliations
  • Chengdu Military General Hospital (CN)
  • Army Medical University (CN)
  • Harvard University (US)
Corresponding author
  • Wang, Jian
  • Xu, Jing
ORCID
Venue
Scientific Reports
Publisher
Springer Science and Business Media LLC
Published
2021-10-08
Volume
11
Issue
1
Pages
20062-20062
ISSN
2045-2322 (ISSN-L)
DOI
10.1038/s41598-021-99527-y
PMC
PMC8501012
OpenAlex
W3203190814
Cited by
14
References
2
Citations by year
2026: 5 · 2025: 4 · 2024: 4 · 2022: 1
FWCI
0.93
Type
journal article
Language
en
Open access
Licence
Locations
  • Scientific Reports (publishedVersion, cc-by)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Chongqing Science and Technology Commission (ctstc2015shmszx120014)
  • Chongqing Xinqiao Hospital, Second Affiliated Hospital of Army Medical University (2014YLC20)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Keywords
exenatide, GLP-1 receptor agonists, type 2 diabetes, obesity, overweight, urinary albumin, albuminuria, renal function, FGF21, insulin glargine, glycemic control, inflammatory markers, lipid profile, correlation network analysis
MeSH terms
Exenatide, Blood Glucose, Diabetes Mellitus, Type 2, Female, Fibroblast Growth Factors, Follow-Up Studies, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Male, Middle Aged, Obesity, Prognosis, Prospective Studies, Biomarkers, Case-Control Studies, Overweight

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