The effect of liraglutide and sitagliptin on oxidative stress in persons with type 2 diabetes

Suvanjaa Sivalingam*, Emil List Larsen, Daniel H van Raalte, Marcel H A Muskiet, Mark M Smits, Lennart Tonneijck, Jaap A Joles, Bernt Johan von Scholten, Emilie Hein Zobel, Frederik Persson, Trine Henriksen, Lars Jorge Diaz, Tine W Hansen, Henrik Enghusen Poulsen, Peter Rossing

*Corresponding author for this work

Abstract

Glucagon-like peptide 1 receptor agonists have shown cardioprotective effects which have been suggested to be mediated through inhibition of oxidative stress. We investigated the effect of treatment with a glucagon-like peptide 1 receptor agonist (liraglutide) on oxidative stress measured as urinary nucleic acid oxidation in persons with type 2 diabetes. Post-hoc analysis of two independent, randomised, placebo-controlled and double-blinded clinical trials. In a cross-over study where persons with type 2 diabetes and microalbuminuria (LIRALBU, n = 32) received liraglutide (1.8 mg/day) or placebo for 12 weeks in random order, separated by 4 weeks of wash-out. In a parallel-grouped study where obese persons with type 2 diabetes (SAFEGUARD, n = 56) received liraglutide (1.8 mg/day), sitagliptin (100 mg/day) or placebo for 12 weeks. Endpoints were changes in the urinary markers of DNA oxidation (8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG)) and RNA oxidation [8-oxo-7,8-dihydroguanosine (8-oxoGuo)]. In LIRALBU, we observed no significant differences between treatment periods in urinary excretion of 8-oxodG [0.028 (standard error (SE): 0.17] nmol/mmol creatinine, p = 0.87) or of 8-oxoGuo [0.12 (0.12) nmol/mmol creatinine, p = 0.31]. In SAFEGUARD, excretion of 8-oxodG was not changed in the liraglutide group [2.8 (- 8.51; 15.49) %, p = 0.62] but a significant decline was demonstrated in the placebo group [12.6 (- 21.3; 3.1) %, p = 0.02], resulting in a relative increase in the liraglutide group compared to placebo (0.16 nmol/mmol creatinine, SE 0.07, p = 0.02). Treatment with sitagliptin compared to placebo demonstrated no significant difference (0.07 (0.07) nmol/mmol creatinine, p = 0.34). Nor were any significant differences for urinary excretion of 8-oxoGuo liraglutide vs placebo [0.09 (SE: 0.07) nmol/mmol creatinine, p = 0.19] or sitagliptin vs placebo [0.07 (SE: 0.07) nmol/mmol creatinine, p = 0.35] observed. This post-hoc analysis could not demonstrate a beneficial effect of 12 weeks of treatment with liraglutide or sitagliptin on oxidatively generated modifications of nucleic acid in persons with type 2 diabetes.

Original languageEnglish
Article number10624
JournalScientific Reports
Volume11
Issue number1
Pages (from-to)10624
ISSN2045-2322
DOIs
Publication statusPublished - 19 May 2021

Keywords

  • 8-Hydroxy-2'-Deoxyguanosine/urine
  • Adult
  • Aged
  • Diabetes Mellitus, Type 2/pathology
  • Female
  • Guanosine/analogs & derivatives
  • Humans
  • Liraglutide/pharmacology
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Oxidative Stress/drug effects
  • Sitagliptin Phosphate/pharmacology

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