GLP-1 receptor agonists do not affect sodium intake: Exploratory analyses from two randomized clinical trials

Area of Science:

• Endocrinology
• Metabolic Disorders
• Cardiovascular Health

Background:

• Excessive sodium intake is a global health concern, contributing to cardiovascular and renal diseases.
• Glucagon-like peptide receptor agonists (GLP-1 RAs) are used for type 2 diabetes (T2DM) and influence feeding behavior and sodium homeostasis.

Purpose of the Study:

• To investigate if GLP-1 RAs can reduce salt cravings in individuals with T2DM.
• To explore the impact of GLP-1 RAs on sodium intake and appetite regulation.

Main Methods:

• Exploratory analyses from two randomized crossover trials (Study A and Study B).
• Study A: Acute intravenous exenatide or placebo in healthy, obese, and T2DM individuals.
• Study B: 12-week liraglutide versus insulin glargine in T2DM patients, assessing sodium and caloric intake and salt craving via Likert scale.

Main Results:

• Acute exenatide administration reduced sodium intake by up to 30% in Study A, alongside decreased total food intake.
• Prolonged liraglutide treatment in Study B did not alter sodium or total caloric intake.
• Neither acute exenatide nor prolonged liraglutide significantly affected salt craving scores.

Conclusions:

• Acute exenatide reduced sodium intake due to a general decrease in food consumption, not specifically salt craving.
• Prolonged liraglutide treatment did not impact sodium intake or salt craving.
• Further mechanistic studies are warranted to understand GLP-1 RA effects on human sodium balance, considering their known impact on renal sodium excretion and cardiovascular outcomes.