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Free T4 is associated with exenatide-related weight loss in patients with type 2 diabetes mellitus and obesity

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Abstract

Background

Factors regarding exenatide-related weight loss have been underrecognized. We aimed to reveal the association between free T4 (fT4) level and exenatide-related weight loss, and change in thyroid function with exenatide treatment in euthyroid adult patients with type 2 diabetes and obesity.

Methods

We included euthyroid adult patients with type 2 diabetes and obesity whom exenatide was added to metformin treatment. We excluded those with contraindication to exenatide or history of thyroid dysfunction. We analyzed baseline demographic, clinical and laboratory features, and the change (difference between the last [6th month] and baseline levels) in body weight, body mass index (BMI), TSH, fT4, fasting blood glucose, HbA1c. We grouped them as Group A: weight loss-absent vs. Group B: weight loss-present (<10%/ ≥10%).

Results

In total (n = 106), TSH-change was -0.077(±1.10), and fT4-change -0.0123(±0.20) (p = 0.229 and p = 0.908, respectively). TSH decreased more in group A than in Group B (p = 0.018). Baseline and the last fT4 levels were higher in group B (p = 0.010 and p = 0.004, respectively). ROC curve analysis indicated that baseline fT4 (cut-off:1.16 ng/dL, AUC:0.708, p = 0.010) was associated with weight loss. The ratio of patients having higher baseline fT4 (≥1.16) was higher in group B (p = 0.016). Baseline BMI (≥40 kg/m2) and fT4 (≥1.16 ng/dL) levels were positive predictors for weight loss (p = 0.024 and p = 0.013, respectively). Decrease in BMI was negatively correlated with baseline BMI (p = 0.002).

Conclusion

Exenatide provides more weight loss in the patients with higher baseline BMI or fT4. Thyroid function remains unchanged during treatment.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

The authors assure that this paper has not been published before nor has been submitted for publication to another scientific journal.

The abstract of our article was accepted and presented as an “Audio Electronic Poster” (AEP-223) with a heading of “Free T4 is associated with exenatide-related weight loss in patients with type 2 diabetes mellitus” in 2021 online congress of European Society of Endocrinology (e-ECE 2021) and as an oral presentation in Endokurs-5 2021 (S-22).

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Acknowledgments

All authors contributed to the study conception and design. Study design, material preparation, data collection and analysis were performed by Ömercan Topaloğlu and Didem Yıldız Toksöz. The first draft of the manuscript was written by Ömercan Topaloğlu and co-author commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Author notes

  1. Ömercan Topaloğlu

    Present address: Department of Endocrinology and Metabolism, Zonguldak Bülent Ecevit University Medical Faculty, Zonguldak, Türkiye

Authors and Affiliations

  1. Endocrinology Clinics, Kocaeli Derince Training and Research Hospital, İbni Sina Street, Lojman Avenue, 41900, Kocaeli, Türkiye

    Ömercan Topaloğlu

  2. Internal Medicine Clinics, Kocaeli Derince Training and Research Hospital, 41900, Kocaeli, Türkiye

    Didem Yıldız Toksöz

Authors
  1. Ömercan Topaloğlu
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  2. Didem Yıldız Toksöz
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Correspondence to Ömercan Topaloğlu.

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Ethics approval and consent to participate

This observational, retrospective cohort study was approved by the Ethics Committee of our institution (University of Health Sciences, Kocaeli Derince Training and Research Hospital; approval number 2020/73) and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Written informed consent was obtained from all participants.

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Written informed consent was given by all the participants included in the study.

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Topaloğlu, Ö., Toksöz, D.Y. Free T4 is associated with exenatide-related weight loss in patients with type 2 diabetes mellitus and obesity. Int J Diabetes Dev Ctries 44, 53–59 (2024). https://doi.org/10.1007/s13410-023-01197-1

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