Skip to main content
SpringerLink
Log in

Early effect of exenatide treatment on atherogenicity in patients with type 2 diabetes mellitus

  • Original Article
  • Published:
International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Objective

Diabetes mellitus is a chronic metabolic disease often associated with hyperlipidemia. High low-density lipoprotein cholesterol (LDLc), high triglyceride, and low high-density lipoprotein cholesterol (HDLc) form the atherogenic lipoprotein profile. In this study, we examined how exenatide, a glucagon-like peptide 1 (GLP-1) analog, affects lipid profile and atherogenic indices in patients with diabetes.

Methods

100 patients diagnosed with type 2 diabetes mellitus (T2DM) participated in this retrospective study. Clinical and laboratory data of the patients were obtained before exenatide treatment and at the 12th week. From the lipid profile, Atherogenicity Plasma Index (AIP), Castelli Risk Index I (CRI-I), Castelli Risk Index II (CRI-II), Atherogenic Coefficient (AC), triglyceride (TG)/HDLc, TG- Glucose index (TyG) and TyG-Body Mass Index (BMI) data were calculated.

Results

There was a significant improvement in body weight (BW), BMI, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), and conventional lipid profile after exenatide treatment. Statistically, significant decreases were observed in atherogenicity indices TyG index, TyG-BMI index, CRI-I, CRI-II, AIP, and AC indices (p < 0.05). This improvement in TG/HDLc, TyG index, CRI-I, CRI-II, AIP and AC indices was independent of HbA1c and BMI. Especially in patients with BMI ≥ 40 kg/m2, TyG-BMI index (p:0.01), a statistically significant decrease was observed in TyG index, TyG-BMI index, CRI-I, and AIP values in patients with HbA1c ≥8% (p:0.001, p:0.016, p:0.047, p:0.008).

Conclusion

In addition to its commonly known effects such as lowering FPG levels and weight loss, exenatide has been observed to have a positive effect on traditional lipid profiles and atherogenicity-related indices. In addition to its antidiabetic effect, it should be considered in diabetic patients in treatment options for atherosclerotic cardiovascular prevention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Martins EB, Lima EB, Pitta FG, et al. Pharmacological therapy and cardiovascular risk reduction for type 2 diabetes. Rev Assoc Med Bras. 2020; https://doi.org/10.1590/1806-9282.66.9.1283.

  2. Klen J, Dolžan V. Glucagon-like peptide-1 receptor agonists in the management of type 2 diabetes mellitus and obesity: The impact of pharmacological properties and genetic factors. Int J Mol Sci. 2022; https://doi.org/10.3390/ijms23073451.

  3. Min T and Bain SC. The role of tirzepatide, dual GIP and GLP-1 receptor agonist, in the management of type 2 diabetes: the SURPASS clinical trials. Diabetes Ther. 2021; https://doi.org/10.1007/s13300-020-00981-0.

  4. Jastreboff AM, Aronne LJ, Ahmad NN, et al., Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022; https://doi.org/10.1056/NEJMoa2206038.

  5. Mirzaei F, Khodadadi I, Majdoub N, et al. Role of glucagon-like peptide-1 (GLP-1) agonists in the management of diabetic patients with or without COVID-19. Open J Med Chem. 2022; https://doi.org/10.2174/18741045-v16-e2212130.

  6. Tamborlane WV, Bishai R, Geller D, et al. Once-weekly exenatide in youth with type 2 diabetes. Diabetes Care 2022; https://doi.org/10.2337/dc21-2275.

  7. Organization WH. WHO European regional obesity report 2022. 2022; World Health Organization. Regional Office for Europe.

  8. Brown E, Wilding JPH, Barber TM, et al. Weight loss variability with SGLT2 inhibitors and GLP-1 receptor agonists in type 2 diabetes mellitus and obesity: Mechanistic possibilities. Obes Rev. 2019; https://doi.org/10.1111/obr.12841.

  9. Fahed G, Aoun L, Zerdan MB, et al. Metabolic syndrome: Updates on pathophysiology and management in 2021. Int J Mol Sci. 2022; https://doi.org/10.3390/ijms23020786.

  10. Vekic J, Zeljkovic A, Cicero AFG, et al. Atherosclerosis development and progression: the role of atherogenic small, dense LDL. Medicina. 2022; https://doi.org/10.3390/medicina58020299.

  11. Zhu X, Yu L, Zhou H, et al. Atherogenic index of plasma is a novel and better biomarker associated with obesity: a population-based cross-sectional study in China. Lipids Health Dis. 2018; https://doi.org/10.1186/s12944-018-0686-8.

  12. Abid HA, ZS Abid, and Abid SA. Atherogenic indices in clinical practice and biomedical research: a short review. Baghdad J Biochem Appl Biol Sci. 2021; 10.47419/bjbabs.v2i02.52.

  13. Si Y, Fan W, Han C, et al. Atherogenic index of plasma, triglyceride-glucose index and monocyte-to-lymphocyte ratio for predicting subclinical coronary artery disease. Am J Med Sci. 2021; https://doi.org/10.1016/j.amjms.2021.05.001.

  14. Xing Y, Chen J, Liu J, Ma H. Associations between GGT/HDL and MAFLD: a cross-sectional study. Diabetes Metab Syndr Obes. 2022;15:383–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Berberich AJ, Hegele RA. Lipid effects of glucagon-like peptide 1 receptor analogs. Curr Opin Lipidol 2021; https://doi.org/10.1097/MOL.0000000000000750.

  16. Andrikou E, Tsioufis C, Andrikou I, et al. GLP-1 receptor agonists and cardiovascular outcome trials: an update. Hell J Cardiol 2019; https://doi.org/10.1016/j.hjc.2018.11.008.

  17. Vekic J, Zeljkovic A, Rasadi KA, et al. A new look at novel cardiovascular risk biomarkers: the role of atherogenic lipoproteins and innovative antidiabetic therapies. Metabolites. 2022; https://doi.org/10.3390/metabo12020108.

  18. Matikainen N, Söderlund S, Björnson E, et al. Liraglutide treatment improves postprandial lipid metabolism and cardiometabolic risk factors in humans with adequately controlled type 2 diabetes: A single-centre randomized controlled study. Diabetes Obes Metab. 2019; https://doi.org/10.1111/dom.13487.

  19. Hjerpsted JB, Flint A, Brooks A, et al. Semaglutide improves postprandial glucose and lipid metabolism, and delays first-hour gastric emptying in subjects with obesity. Diabetes Obes Metab. 2018; https://doi.org/10.1111/dom.13120.

  20. Giorgino F, Shaunik A, Liu M, Saremi A. Achievement of glycaemic control is associated with improvements in lipid profile with iGlarLixi versus iGlar: A post hoc analysis of the LixiLan-L trial. Diabetes Obes Metab. 2019; https://doi.org/10.1111/dom.13857.

  21. Holman RR, Bethel MA, Mentz RJ, et al. Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2017; https://doi.org/10.1056/NEJMoa1612917.

  22. Marso SP, Bain SC, Consoli A, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016; https://doi.org/10.1056/NEJMoa1607141.

  23. Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016; https://doi.org/10.1056/NEJMoa1603827.

  24. Hernandez AF, Green JB, Janmohamed S, et al. Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial. Lancet. 2018; https://doi.org/10.1016/S0140-6736(18)32261-X.

  25. Bhardwaj S, Bhattacharjee J, Bhatnagar MK, Tyagi S. Atherogenic index of plasma, castelli risk index and atherogenic coefficient-new parameters in assessing cardiovascular risk. Int J Pharm Biol Sci. 2013;3(3):359–64.

    Google Scholar 

  26. Yang G, Lei Y, Inoue A, et al. Exenatide mitigated diet-induced vascular aging and atherosclerotic plaque growth in ApoE-deficient mice under chronic stress. Atherosclerosis. 2017; https://doi.org/10.1016/j.atherosclerosis.2017.07.014.

  27. Nikolic D, Giglo RV, Rizvi AA, et al. Liraglutide reduces carotid intima-media thickness by reducing small dense low-density lipoproteins in a real-world setting of patients with type 2 diabetes: A novel anti-atherogenic effect. Diabetes Ther. 2021; https://doi.org/10.1007/s13300-020-00962-3.

Download references

Acknowledgment

Preparation for publication of this article is supported by the Society of Endocrinology and Metabolism of Turkey.

Funding

No funding has been received for the conduct of this study.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Aksaray Training and Research Hospital, Aksaray, Turkey

    Burak Menekşe

  2. Department of Endocrinology and Metabolism, Koc University, School of Medicine, Istanbul, Turkey

    Adnan Batman

Authors
  1. Burak Menekşe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Adnan Batman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Adnan Batman.

Ethics declarations

Ethics clearance

This study was approved by the Aksaray University Faculty of Medicine clinical research ethics committee (Date: 19.08.2021, Decision no: 2021/08-08). The Declaration of Helsinki (1964) of the World Medical Association guided the execution of this study.

Conflict of interest

The authors have no conflict of interest to declare regarding the content of this article.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Menekşe, B., Batman, A. Early effect of exenatide treatment on atherogenicity in patients with type 2 diabetes mellitus. Int J Diabetes Dev Ctries 44, 200–209 (2024). https://doi.org/10.1007/s13410-023-01233-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13410-023-01233-0

Keywords

Search

Navigation