Exenatide Affects Circulating Cardiovascular Risk Biomarkers Independently of Changes in Body Composition

Introduction: This study's aim was to investigate the effect of exenatide treatment in addition to metformin in patients with type 2 diabetes; the effects on body composition and circulating cardiovascular risk biomarkers were studied.

Methods: Sixty-nine metformin-treated patients with type 2 diabetes were randomized to receive either exenatide or insulin glargine. They were treated for 1 year. During that time, body composition was evaluated by dual-energy x-ray absorptiometry. Patients' body weight, waist circumference, and cardiovascular biomarkers were also measured.

Results: The treatment with exenatide lasted one year and at the end of the treatment period, the group of patients who received exenatide showed a 5% decrease in body weight, an 11% reduction in total body fat mass, a 15% decrease in truncal fat mass, and a 5% decrease in waist circumference. The latter two are important findings in subjects with increased cardiovascular risk such as metabolic syndrome and diabetes. In addition, the treatment with exenatide for 1 year resulted in the significant changes in biomarkers of cardiovascular risk, such as a 61% decrease of high-sensitivity C- reactive protein (CRP) and 14% decrease in leptin levels, and 19% increase in adiponectin levels.

Commentary by Grazia Aleppo MD, FACE, FACP

This study was chosen because it is the first report of beneficial effects on biomarkers of cardiovascular risk with long-term use of the GLP-1 receptor agonist exenatide. It also demonstrates a significant decrease of total body fat mass and truncal fat mass and waist circumference while using exenatide.