Semaglutide Therapy and Cardiorenal Risk Management in Type 2 Diabetes: hsCRP as a Biomarker of Risk

Background: Inflammation plays a key role in the pathogenesis of type 2 diabetes (T2D) and the associated cardiovascular complications. High-sensitivity C-reactive protein (hsCRP) is a widely used marker of systemic inflammation as well as a predictor of cardiovascular risk. Objective: There is increasing evidence that glucagon-like peptide-1 receptor agonists (GLP-1RAs), including semaglutide, may have effects on hsCRP levels, independent of their effects on glycemic control and body weight loss. This purpose of our study is to explore the effect of semaglutide on hsCRP levels in patients with type 2 diabetes. Additionally, we aimed to determine whether the observed effect of semaglutide on hsCRP is fully mediated by changes in HbA1c and body weight, or whether there is a direct effect suggesting the presence of an independent anti-inflammatory mechanism. Methods: The study included 70 outpatients with diagnosed type 2 diabetes undergoing therapy with metformin and/or a sulfonylurea. Semaglutide was added to the existing therapeutic regimen. All participants were followed up after a 6-month a period. At the beginning and at the end of the study, the hsCRP values, some selected indicators of glycemic control, and the anthropometric measurements were recorded. Results: The mean hsCRP value at baseline was 4.90 ± 1.21 mg/L, while after six-month therapy, it dropped to 2.23 ± 2.21 mg/L. Conclusions: The results of the analysis have a good potential to contribute to a better understanding of the pleiotropic effects of GLP-1 RAs and support the hypothesis of a direct anti-inflammatory role of semaglutide, which could have clinical significance in the context of cardiometabolic risk management in patients with type 2 diabetes.