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01.12.2012 | Original investigation | Ausgabe 1/2012 Open Access

Cardiovascular Diabetology 1/2012

Effects of Exenatide vs. Metformin on endothelial function in obese patients with pre-diabetes: a randomized trial

Zeitschrift:
Cardiovascular Diabetology > Ausgabe 1/2012
Autoren:
Aaron S Kelly, Richard M Bergenstal, J Michael Gonzalez-Campoy, Harold Katz, Alan J Bank
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1475-2840-11-64) contains supplementary material, which is available to authorized users.

Authors’ contributions

A.S.K. participated in study design, data collection, data analysis and interpretation, and drafted the manuscript; R.M.B. participated in data collection, data interpretation, and edited the manuscript; J.M.G.C. participated in data interpretation and edited the manuscript; H.K. participated in data interpretation and edited the manuscript; A.J.B. participated study design, data collection, data interpretation, and edited the manuscript.

Abstract

Background

Glucagon like peptide-1 (GLP-1) receptor agonist treatment may improve endothelial function via direct and indirect mechanisms. We compared the acute and chronic effects of the GLP-1 receptor agonist exenatide vs. metformin on endothelial function in patients with obesity and pre-diabetes.

Methods

We performed a randomized, open-label, clinical trial in 50 non-diabetic individuals (mean age 58.5 ± 10.0; 38 females) with abdominal obesity and either impaired fasting glucose, elevated HbA1c, or impaired glucose tolerance (IGT) who were randomized to receive 3-months of exenatide or metformin. Microvascular endothelial function, assessed by digital reactive hyperemia (reactive hyperemic index: RHI), C-reactive protein (CRP), circulating oxidized LDL (oxLDL), and vascular cell adhesion molecule-1 (VCAM-1) were measured at baseline and 3-months. Seven subjects with IGT participated in a sub-study comparing the effects of pre-administration of exenatide and metformin on postprandial endothelial function.

Results

There were no differences for the change in RHI (Δ exenatide: 0.01 ± 0.68 vs. Δ metformin: -0.17 ± 0.72, P = 0.348), CRP, oxLDL, or VCAM-1 between exenatide and metformin treatment. Triglycerides were reduced more with exenatide compared to metformin (Δ exenatide: -25.5 ± 45.7 mg/dL vs. Δ metformin: -2.9 ± 22.8 mg/dL, P = 0.032). In the sub-study, there was no difference in postprandial RHI between exenatide and metformin.

Conclusions

Three months of exenatide therapy had similar effects on microvascular endothelial function, markers of inflammation, oxidative stress, and vascular activation, as metformin, in patients with obesity and pre-diabetes.

Clinical trials registration

Zusatzmaterial
Authors’ original file for figure 1
12933_2012_495_MOESM1_ESM.pdf
Authors’ original file for figure 2
12933_2012_495_MOESM2_ESM.pdf
Literatur
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