Effects of 3-month liraglutide treatment on oxidative stress and inflammation in type 2 diabetes patients with different urinary albumin-to-creatinine ratio categories

This study evaluates the effects of liraglutide on albuminuria, oxidative stress, and inflammation in type 2 diabetes (T2D) patients with different urinary albumin-to-creatinine ratio (UACR) categories. We enrolled 107 patients with T2D who were initiating liraglutide for glycemic control. Patients were categorized into 3 groups: group I (UACR < 30 mg/g); group II (30 mg/g <= UACR <= 300 mg/g); group III (UACR > 300 mg/g). We observed the changes in body mass index, fasting plasma glucose, glycated hemoglobin, lipid profile, serum liver enzymes, creatinine, uric acid, cystatin C, UACR, as well as oxidative stress and inflammation biomarkers such as tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), monocyte chemotactic protein-1 (MCP-1), malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase before and after 3 months of liraglutide treatment. After 3-month liraglutide treatment, fasting plasma glucose, glycated hemoglobin, and body mass index significantly decreased in all 3 groups regardless of the baseline UACR (all P < .05). UACR significantly decreased in groups II (P = .005) and III (P = .001). Patients with higher UACR at baseline showed significantly greater albuminuria reduction (P < .001). Compared with baseline, TNF-alpha, IL-6, MCP-1, and MDA were remarkably decreased, while SOD and glutathione peroxidase were significantly increased in all 3 groups (P < .05). UACR at baseline showed a positive correlation with TNF-alpha, IL-6, and MDA, and a negative correlation with SOD at baseline. The change in UACR was negatively correlated with UACR, TNF-alpha, and MDA at baseline, while it was positively correlated with SOD at baseline, and also positively correlated with the change in MCP-1. Liraglutide ameliorated albuminuria in T2D patients with microalbuminuria and macroalbuminuria. The renoprotective effect of liraglutide was associated with the alleviation of oxidative stress and inflammation. These findings may provide new therapeutic strategies for patients with diabetic kidney disease.