Renal effects of glucagon-like peptide receptor agonists in patients with type 1 diabetes mellitus


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Abstract

The purpose of our study is to assess the effects of glucagon-like peptide-1 receptor agonists (GLP-1R agonists) on early markers of kidney damage in patients with type 1 diabetes mellitus (DM). Materials and methods. The study included 27 patients with type 1 diabetes with normo- (n=16) and microalbuminuria (n=11) on intensive insulin injection regimen with insulin analogs. Patients were divided into two groups: 15 patients continued insulin therapy throughout the follow-up period, 12 patients were given 1.2 mg GLP-1R agonist (Liraglutide) once a day in addition to the insulin therapy for 6 months. HbA1c, lipid profile, classic markers of kidney damage (albuminuria, creatinine, glomerular filtration rate); plazma (neutrophilic gelatinase-associated lipoxalin - NGAL, molecule renal damage of type 1 - KIM-1, cystatin C, osteopontin) and urinary kidney biomarkers (nephrin, podocyne, uromodulin, NGAL, KIM-1, collagen type IV, cystatin C) were evaluated prior and in dynamics at 6 months. Kidney biomarkers levels were assessed by the enzyme-linked immunosorbent assay (ELISA). Results. We observed a significant decrease in the urinary excretion of type IV collagen, cystatin C, increased uromodulin excretion and decrease in the plasma levels of osteopontin, NGAL and cystatin C in the group of combined insulin and GLP-1R agonist therapy. Conclusions. Changes in the level of sensitive kidney biomarkers indicate a possible renoprotective effect of GLP-1R agonist therapy in patients with type 1 diabetes at an early stages of kidney damage.

About the authors

O K Vikulova

Endocrinology Research Centre, Ministry of Health of the Russia

Email: olga-vikulova-1973@yandex.ru
к.м.н., зав. отд-нием эпидемиологии и государственного регистра сахарного диабета, ведущий научный сотрудник НМИЦ эндокринологии; тел.: +7(495)668-20-77; e-mail: olga-vikulova-1973@yandex.ru; ORCID: 0000-0003-0571-8882 Moscow, Russia

Z T Zuraeva

Endocrinology Research Centre, Ministry of Health of the Russia

н.с. НМИЦ эндокринологии Moscow, Russia

O V Michaleva

Endocrinology Research Centre, Ministry of Health of the Russia

аспирант НМИЦ эндокринологии Moscow, Russia

L V Nikankina

Endocrinology Research Centre, Ministry of Health of the Russia

к.м.н., в.н.с. клинико-диагностической лаборатории НМИЦ эндокринологии Moscow, Russia

M Sh Shamkhalova

Endocrinology Research Centre, Ministry of Health of the Russia

д.м.н., зав. отд-нием диабетической болезни почек и посттрансплантационной реабилитации НМИЦ эндокринологии Moscow, Russia

M V Shestakova

Endocrinology Research Centre, Ministry of Health of the Russia

академик РАН, д.м.н., проф., зам. директора Центра по научной работе, директор Института диабета НМИЦ эндокринологии Moscow, Russia

I I Dedov

Endocrinology Research Centre, Ministry of Health of the Russia

академик РАН, д.м.н., проф., директор НМИЦ эндокринологии, член президиума РАН, президент Российской ассоциации эндокринологов, главный внештатный специалист-эксперт эндокринолог Минздрава России Moscow, Russia

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