Effects of liraglutide on cardiovascular risk biomarkers in patients with type 2 diabetes and albuminuria: A sub‐analysis of a randomized, placebo‐controlled, double‐blind, crossover trial

We assessed the effects of liraglutide treatment on five cardiovascular risk biomarkers, reflecting different pathophysiology: tumour necrosis factor ( TNF )‐α; soluble urokinase plasminogen activator receptor ( suPAR ); mid‐regional pro‐adrenomedullin ( MR‐proADM ); mid‐regional pro‐atrial natriuretic peptide ( MR‐proANP ); and copeptin, in people with type 2 diabetes with albuminuria. In a randomized, double‐blind, placebo‐controlled, crossover trial we enrolled people with type 2 diabetes and persistent albuminuria (urinary albumin‐to‐creatinine ratio UACR >30 mg/g) and estimated glomerular filtration rate ( eGFR ) ≥30 mL /min/1.73 m 2 . Participants received liraglutide (1.8 mg/d) and matched placebo for 12 weeks, in random order. The primary endpoint was change in albuminuria; this was a prespecified sub‐study. A total of 32 participants were randomized, of whom 27 completed the study. TNF ‐α level was 12% (95% confidence interval CI 3; 20) lower after liraglutide treatment compared with placebo ( P = .012); MR‐proADM level was 4% (95% CI 0; 8) lower after liraglutide treatment compared with placebo ( P = .038), and MR‐proANP level was 13% (95% CI 4; 21) lower after liraglutide treatment compared with placebo ( P = .006). In the present study, we showed anti‐inflammatory effects of liraglutide treatment, reflected in reductions in levels of TNF ‐α and MR‐proADM , while the reduction in MR‐proANP levels may represent a clinically relevant benefit with regard to heart failure.