Effects of exenatide vs. metformin on endothelial function in obese patients with pre-diabetes: a randomized trial.

Kelly AS, Bergenstal RM, Gonzalez-Campoy JM, Katz H, Bank AJ

Cardiovascular diabetology8 Jun 2012Cited by 82 (Europe PMC)

PMID22681705PMCIDPMC3434036DOI10.1186/1475-2840-11-64PepBankPUB-22681705

Summary

BackgroundGlucagon like peptide-1 (GLP-1) receptor agonist treatment may improve endothelial function via direct and indirect mechanisms. We compared the acute and chronic effects of the GLP-1 receptor agonist exenatide vs. metformin on endothelial function in patients with obesity and pre-diabetes.MethodsWe performed a randomized, open-label, clinical trial in 50 non-diabetic individuals (mean age 58.5 ± 10.0; 38 females) with abdominal obesity and either impaired fasting glucose, elevated HbA1c, or impaired glucose tolerance (IGT) who were randomized to receive 3-months of exenatide or metformin. Microvascular endothelial function, assessed by digital reactive hyperemia (reactive hyperemic index: RHI), C-reactive protein (CRP), circulating oxidized LDL (oxLDL), and vascular cell adhesion molecule-1 (VCAM-1) were measured at baseline and 3-months. Seven subjects with IGT participated in a sub-study comparing the effects of pre-administration of exenatide and metformin on postprandial endothelial function.ResultsThere were no differences for the change in RHI (Δ exenatide: 0.01 ± 0.68 vs. Δ metformin: -0.17 ± 0.72, P = 0.348), CRP, oxLDL, or VCAM-1 between exenatide and metformin treatment. Triglycerides were reduced more with exenatide compared to metformin (Δ exenatide: -25.5 ± 45.7 mg/dL vs. Δ metformin: -2.9 ± 22.8 mg/dL, P = 0.032). In the sub-study, there was no difference in postprandial RHI between exenatide and metformin.ConclusionsThree months of exenatide therapy had similar effects on microvascular endothelial function, markers of inflammation, oxidative stress, and vascular activation, as metformin, in patients with obesity and pre-diabetes.Clinical trials registrationThis study is registered on http://www.clinicaltrials.gov/: NCT00546728.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study6

6 results from studies that gave the peptide. 6 results from people.

01HumanRandomized controlled trialEfficacy outcome
In adults with obesity and pre-diabetes, RHI change did not differ between exenatide and metformin.
In plain wordsIn adults with obesity and pre-diabetes, blood vessel function changes did not differ between exenatide and metformin.
Peptide
Exenatide (exendin-4)
Outcome
No significant changeReactive hyperemic index change
Study
n = 50
Comparator
metformin
Outcome group
Vascular function · Cardiovascular
Studied dose
Dose not stated · 3 monthsAs given in this study (human).
Measurements
Change in RHI
0.01 RHI units
exenatide
Change in RHI
−0.17 RHI units
metformin
Source sentences
Summary
There were no differences for the change in RHI (Δ exenatide: 0.01 ± 0.68 vs. Δ metformin: -0.17 ± 0.72, P = 0.348), CRP, oxLDL, or VCAM-1 between exenatide and metformin treatment.
1 context sentence(design, population, supporting numbers)
Summary · context
We performed a randomized, open-label, clinical trial in 50 non-diabetic individuals (mean age 58.5 ± 10.0; 38 females) with abdominal obesity and either impaired fasting glucose, elevated HbA1c, or impaired glucose tolerance (IGT) who were randomized to receive 3-months of exenatide or metformin.
Show in the study text Report a problemFND-2268170501
02HumanRandomized controlled trialEfficacy outcome
In adults with obesity and pre-diabetes, CRP change did not differ between exenatide and metformin.
In plain wordsIn adults with obesity and pre-diabetes, CRP changes did not differ between exenatide and metformin.
Peptide
Exenatide (exendin-4)
Outcome
No significant changeC-reactive protein change
Study
n = 50
Comparator
metformin
Outcome group
Inflammation markers · Immune and inflammation
Studied dose
Dose not stated · 3 monthsAs given in this study (human).
Source sentences
Summary
There were no differences for the change in RHI (Δ exenatide: 0.01 ± 0.68 vs. Δ metformin: -0.17 ± 0.72, P = 0.348), CRP, oxLDL, or VCAM-1 between exenatide and metformin treatment.
1 context sentence(design, population, supporting numbers)
Summary · context
We performed a randomized, open-label, clinical trial in 50 non-diabetic individuals (mean age 58.5 ± 10.0; 38 females) with abdominal obesity and either impaired fasting glucose, elevated HbA1c, or impaired glucose tolerance (IGT) who were randomized to receive 3-months of exenatide or metformin.
Show in the study text Report a problemFND-2268170502
03HumanRandomized controlled trialEfficacy outcome
In adults with obesity and pre-diabetes, oxidized LDL change did not differ between exenatide and metformin.
In plain wordsIn adults with obesity and pre-diabetes, oxidized LDL changes did not differ between exenatide and metformin.
Peptide
Exenatide (exendin-4)
Outcome
No significant changeOxidized LDL change
Study
n = 50
Comparator
metformin
Outcome group
Lipids · Cardiovascular
Studied dose
Dose not stated · 3 monthsAs given in this study (human).
Source sentences
Summary
There were no differences for the change in RHI (Δ exenatide: 0.01 ± 0.68 vs. Δ metformin: -0.17 ± 0.72, P = 0.348), CRP, oxLDL, or VCAM-1 between exenatide and metformin treatment.
1 context sentence(design, population, supporting numbers)
Summary · context
We performed a randomized, open-label, clinical trial in 50 non-diabetic individuals (mean age 58.5 ± 10.0; 38 females) with abdominal obesity and either impaired fasting glucose, elevated HbA1c, or impaired glucose tolerance (IGT) who were randomized to receive 3-months of exenatide or metformin.
Show in the study text Report a problemFND-2268170503
04HumanRandomized controlled trialEfficacy outcome
In adults with obesity and pre-diabetes, VCAM-1 change did not differ between exenatide and metformin.
In plain wordsIn adults with obesity and pre-diabetes, VCAM-1 changes did not differ between exenatide and metformin.
Peptide
Exenatide (exendin-4)
Outcome
No significant changeVCAM-1 change
Study
n = 50
Comparator
metformin
Outcome group
Inflammation markers · Cardiovascular
Studied dose
Dose not stated · 3 monthsAs given in this study (human).
Source sentences
Summary
There were no differences for the change in RHI (Δ exenatide: 0.01 ± 0.68 vs. Δ metformin: -0.17 ± 0.72, P = 0.348), CRP, oxLDL, or VCAM-1 between exenatide and metformin treatment.
1 context sentence(design, population, supporting numbers)
Summary · context
We performed a randomized, open-label, clinical trial in 50 non-diabetic individuals (mean age 58.5 ± 10.0; 38 females) with abdominal obesity and either impaired fasting glucose, elevated HbA1c, or impaired glucose tolerance (IGT) who were randomized to receive 3-months of exenatide or metformin.
Show in the study text Report a problemFND-2268170504
05HumanRandomized controlled trialEfficacy outcome
In adults with obesity and pre-diabetes, exenatide reduced triglycerides more than metformin.
In plain wordsIn adults with obesity and pre-diabetes, exenatide reduced triglycerides more than metformin.
Peptide
Exenatide (exendin-4)
Outcome
DecreaseTriglycerides
Study
n = 50
Comparator
metformin
Outcome group
Lipids · Metabolic and weight
Studied dose
Dose not stated · 3 monthsAs given in this study (human).
Measurements
Triglyceride change
−25.5 mg/dL
exenatide
Triglyceride change
−2.9 mg/dL
metformin
Source sentences
Summary
Triglycerides were reduced more with exenatide compared to metformin (Δ exenatide: -25.5 ± 45.7 mg/dL vs. Δ metformin: -2.9 ± 22.8 mg/dL, P = 0.032).
1 context sentence(design, population, supporting numbers)
Summary · context
We performed a randomized, open-label, clinical trial in 50 non-diabetic individuals (mean age 58.5 ± 10.0; 38 females) with abdominal obesity and either impaired fasting glucose, elevated HbA1c, or impaired glucose tolerance (IGT) who were randomized to receive 3-months of exenatide or metformin.
Show in the study text Report a problemFND-2268170505
06HumanRandomized controlled trialEfficacy outcome
In participants with impaired glucose tolerance, postprandial RHI did not differ between exenatide and metformin.
In plain wordsIn participants with impaired glucose tolerance, blood vessel function after meals did not differ between exenatide and metformin.
Peptide
Exenatide (exendin-4)
Outcome
No significant changePostprandial RHI
Study
n = 7
Comparator
metformin
Outcome group
Vascular function · Cardiovascular
Studied dose
Dose not stated
Source sentences
Summary
In the sub-study, there was no difference in postprandial RHI between exenatide and metformin.
2 context sentences(design, population, supporting numbers)
Summary · context
Seven subjects with IGT participated in a sub-study comparing the effects of pre-administration of exenatide and metformin on postprandial endothelial function.
Summary · context
We performed a randomized, open-label, clinical trial in 50 non-diabetic individuals (mean age 58.5 ± 10.0; 38 females) with abdominal obesity and either impaired fasting glucose, elevated HbA1c, or impaired glucose tolerance (IGT) who were randomized to receive 3-months of exenatide or metformin.
Show in the study text Report a problemFND-2268170506

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Registered trials1

Trials this study reports on, or that list this study as a reference. Registry data from ClinicalTrials.gov.

1 trial · 1 completed · 1 with posted results · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 4Results postedNCT00546728

The Vascular Effects of Exenatide Versus Metformin in Patients With Pre-Diabetes

St. Paul Heart Clinicn = 50Oct 2007 to Jul 2011

Impaired Glucose Tolerance

Trial page ClinicalTrials.govUpdated 8 Nov 2013

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
22 Oct 2026, 02:26 UTC
Study results updated
Version 1
21 Oct 2026, 18:59 UTC
First added · source update from Europe PMC

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