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Circulating GDF15 and HbA1c Response to Add-On Exenatide Therapy in Type 2 Diabetes: A Post Hoc Analysis from a
Qi Wu1, Kun Yang1, Xinyue Liao1
1Department of Endocrinology and Metabolism, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Peking University Third Hospital, Beijing 100191, China.
Higher levels of growth differentiation factor 15 (GDF15) may reduce the effectiveness of exenatide treatment in lowering glycated hemoglobin (HbA1c) for type 2 diabetes patients, especially in those over 35 years old.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Pharmacology
Background:
- Type 2 diabetes mellitus (T2DM) management often involves therapies targeting glycemic control.
- Exenatide is a glucagon-like peptide-1 receptor agonist used in T2DM treatment.
- Growth differentiation factor 15 (GDF15) is a cytokine with potential roles in metabolic regulation.
Purpose of the Study:
- To investigate the association between baseline GDF15 levels and the reduction in glycated hemoglobin (ΔHbA1c) achieved with exenatide therapy in T2DM patients.
- To determine if age influences the relationship between GDF15 and exenatide's efficacy.
Main Methods:
- A cohort of 166 T2DM participants receiving exenatide add-on therapy for 16 weeks was analyzed.
- Univariate, multivariate, and bidirectional stepwise linear regression models were used to assess GDF15's effect on ΔHbA1c.
- Baseline GDF15 levels were categorized into tertiles, and subgroup analysis was performed for participants >35 years old.
Main Results:
- GDF15 levels increased significantly after 16 weeks of exenatide treatment (p=0.031).
- Univariate analysis showed a positive association between higher baseline GDF15 and ΔHbA1c (p=0.014).
- This association was not significant after adjusting for age and diabetes duration in the full cohort, but remained significant in participants >35 years old (p=0.049).
Conclusions:
- Elevated baseline GDF15 may attenuate the HbA1c-lowering effect of 16-week exenatide treatment in T2DM.
- Age appears to be a significant moderator of this relationship, with the effect more pronounced in older individuals.
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