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Updated: Mar 10, 2026

Characterization of Metabolic Status in Nonhuman Primates with the Intravenous Glucose Tolerance Test
Published on: November 13, 2016
Baseline metabolite profiles predict the glucose-lowering efficacy of exenatide in patients with type 2 diabetes
1Department of Endocrinology and Metabolism, State Key Laboratory of Female Fertility Promotion, Peking University Third Hospital, Beijing, China.
Aims:
Individual heterogeneity in the glucose-lowering response to glucagon-like peptide-1 receptor agonists (GLP-1RAs), including exenatide, limits efficient treatment selection for type 2 diabetes mellitus (T2DM). This study assessed whether baseline clinical characteristics together with serum metabolomic features could predict the glucose-lowering efficacy of exenatide.
Methods:
A total of 93 Chinese adults with T2DM received exenatide treatment for 16 weeks. Treatment response was defined by glycated hemoglobin (HbA1c) change value (ΔHbA1c): responders (ΔHbA1c ≤ -0.3%, n = 70) and non-responders (ΔHbA1c > -0.3%, n = 23). Baseline serum metabolites were profiled by non-targeted liquid chromatography-mass spectrometry. Predictors of exenatide-induced glucose-lowering response were screened and modeled using univariate and multivariate logistic regression analysis and evaluated with receiver-operating characteristic (ROC) analysis.
Results:
At baseline, responders presented with a higher HbA1c level and a lower HDL-C level than non-responders. Logistic regression analysis indicated that baseline HbA1c and HDL-C levels were associated with ΔHbA1c after treatment. Metabolomic comparison analysis identified 15 discriminative serum metabolites between two groups. Among these metabolites, butenylcarnitine, LysoPC(18:2(9Z,12Z)) and PC(20:3(5Z,8Z,11Z)/20:3(5Z,8Z,11Z)) were correlated with the exenatide-induced glucose-lowering response. Baseline clinical characteristics (higher HbA1c level and lower HDL-C level) combined with the metabolomic features [lower butenylcarnitine, higher LysoPC(18:2(9Z,12Z)) and higher PC(20:3(5Z,8Z,11Z)/20:3(5Z,8Z,11Z)] predicted better glucose-lowering response to exenatide, with a sensitivity, specificity and area under the ROC curve of 78.1%, 90.0% and 0.895, respectively.
Conclusions:
Combination of the baseline clinical characteristics (HbA1c and HDL-C) and metabolite profiles [butenylcarnitine, LysoPC(18:2(9Z,12Z)) and PC(20:3(5Z,8Z,11Z)/20:3(5Z,8Z,11Z))] can effectively predict glucose-lowering efficacy of exenatide in patients with T2DM.
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