Kun Yang1, Haining Wang1, Rui Wei1, Wenhua Xiao1, Qing Tian1, Chen Wang1, Jin Yang2, Tianpei Hong3. 1. Department of Endocrinology and Metabolism, Peking University Third Hospital, Beijing, 100191, China. 2. Department of Endocrinology and Metabolism, Peking University Third Hospital, Beijing, 100191, China. yangjin@bjmu.edu.cn. 3. Department of Endocrinology and Metabolism, Peking University Third Hospital, Beijing, 100191, China. tpho66@bjmu.edu.cn.
Abstract
AIMS: To investigate the association between fibroblast growth factor 21 (FGF21) levels and glycemic response to exenatide in patients with type 2 diabetes. METHODS: The exploratory analysis of a multi-center trial included 190 patients with type 2 diabetes inadequately controlled bymonotherapy or combination therapy of metformin and insulin secretagogues. All participants received exenatide twice daily as an add-on therapy for 16 weeks. Serum FGF21 and other information at the baseline and end of follow-ups were obtained. Linear regression analysis was used to determine the correlations between baseline FGF21 levels and HbA1c reduction from baseline after the treatment. RESULTS: After 16 weeks of treatment with exenatide, a decline in the HbA1c levels from baseline was associated with higher baseline FGF21 levels among all participants (r = 0.193, P = 0.008) and in subgroup of the participants receiving background metformin monotherapy (r = 0.231, P = 0.034). Compared with patients in the lowest FGF21 quartile, patients in the highest FGF21 quartile showed a significantly weakened decline in HbA1c levels from baseline among all participants (β = - 0.16 [95% Cl - 0.31 to - 0.01], P < 0.05) and in subgroup of the participants receiving background metformin monotherapy (β = - 0.23 [95% Cl - 0.43 to - 0.03], P < 0.05), after adjusting for the confounding factors, including age, sex, and baseline HbA1c levels. CONCLUSIONS: The high baseline FGF21 levels are associated with poor glycemic responses to exenatide in patients with type 2 diabetes. Therefore, FGF21 could be used as a biomarker for predicting the efficacy of exenatide treatment. TRIAL REGISTRATION: ChiCTR-IPR-15006558, date registered May 27, 2015.
RCT Entities:
AIMS: To investigate the association between fibroblast growth factor 21 (FGF21) levels and glycemic response to exenatide in patients with type 2 diabetes. METHODS: The exploratory analysis of a multi-center trial included 190 patients with type 2 diabetes inadequately controlled by monotherapy or combination therapy of metformin and insulin secretagogues. All participants received exenatide twice daily as an add-on therapy for 16 weeks. Serum FGF21 and other information at the baseline and end of follow-ups were obtained. Linear regression analysis was used to determine the correlations between baseline FGF21 levels and HbA1c reduction from baseline after the treatment. RESULTS: After 16 weeks of treatment with exenatide, a decline in the HbA1c levels from baseline was associated with higher baseline FGF21 levels among all participants (r = 0.193, P = 0.008) and in subgroup of the participants receiving background metformin monotherapy (r = 0.231, P = 0.034). Compared with patients in the lowest FGF21 quartile, patients in the highest FGF21 quartile showed a significantly weakened decline in HbA1c levels from baseline among all participants (β = - 0.16 [95% Cl - 0.31 to - 0.01], P < 0.05) and in subgroup of the participants receiving background metformin monotherapy (β = - 0.23 [95% Cl - 0.43 to - 0.03], P < 0.05), after adjusting for the confounding factors, including age, sex, and baseline HbA1c levels. CONCLUSIONS: The high baseline FGF21 levels are associated with poor glycemic responses to exenatide in patients with type 2 diabetes. Therefore, FGF21 could be used as a biomarker for predicting the efficacy of exenatide treatment. TRIAL REGISTRATION: ChiCTR-IPR-15006558, date registered May 27, 2015.
Authors: Angus G Jones; Timothy J McDonald; Beverley M Shields; Anita V Hill; Christopher J Hyde; Bridget A Knight; Andrew T Hattersley Journal: Diabetes Care Date: 2015-08-04 Impact factor: 19.112