Efficacy and safety of liraglutide on C-reactive protein (CRP) in adults with type 2 diabetes: A GRADE-assessed systematic review and dose-response meta-analysis of controlled trials

Background: Liraglutide (LRG) is an analog of glucagon-like-peptide-1 which has beneficial effects on controlling glycemic in diabetes patients. However, the effect of liraglutide on the C-reactive protein (CRP) was controversial in different studies. So, this study aimed to investigate the effect of LRG on CRP in adults with type 2 diabetes (T2DM). Methods: Through March 2024, Web of Science, PubMed, and Scopus electronic databases were searched for pertinent studies. Calculation of 95 % confidence intervals (CIs) and mean differences was done using random effects model. Standard methods assessed dose-response, meta-regression, sensitivity, and publication bias. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) was used to calculate evidence certainty. Results: Finally, after reviewing 9 eligible studies with 10 arms including 1494 participants, a significant decrease in CRP levels was observed after treatment with LRG (WMD =-0.692 mg/L, 95 % CI:-1.01,-0.37, P<0.001). According to the results of the subgroup, LRG had greater effects in obese patients (Body mass index >30), high- quality studies, dosages >1.6 mg/d and durations >24 weeks. Linear (P<0.001) and non-linear (P dose-response =0.009) dose-response associations were observed between LRG dosages and CRP levels. According to the GRADE, evidence for CRP was high. Conclusions: LRG had beneficial effects on CRP levels in adults with T2DM, especially in obese patients.