ArticleActa diabetologica2026
Modulation of circulating osteocalcin-expressing monocytes by glucagon like peptide-1 receptor agonists in type 2 diabetes: an exploratory pilot study.
Article in Acta diabetologica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
contextThe phenotypic drift of circulating monocytes toward osteoblast-like cells expressing osteocalcin (OCN) has been linked to vascular calcification in individuals with type 2 diabetes (T2D). The synergistic action of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and metformin may reduce the cardiovascular risk by modulating OCN-expressing monocytes, representing a novel mechanism of cardiovascular protection.
objectiveTo investigate the impact of GLP-1 RA add-on metformin therapy on the percentage of circulating CD14 RESEARCH DESIGN AND
methodsThis longitudinal study enrolled patients with T2D receiving metformin monotherapy who either initiated GLP-1 RA therapy (Group A, n = 7) or did not (Group B, n = 28). Clinical parameters and circulating CD14+OCN+ cell levels were assessed at baseline (V0), after 1 week (V1) and after 12 weeks (V2). In vitro experiments were conducted using peripheral blood mononuclear cells (PBMCs) from healthy volunteers (n = 10), treated with metformin or exendin-4 for 24 h.
resultsIn group A, the percentage of CD14+OCN+ significantly decreased from baseline (4.5 [2.5-7.6]) to V2 (2.2 [1.73-4.9]% p = 0.019). This reduction was already significant at V1 (p = 0.039). No significant change over time was observed in Group B (p = 0.31). In vitro treatment of PBMCs with metformin significantly reduced the percentage of CD14
conclusionGLP-1 RA add-on therapy to metformin reduces OCN expression in circulating monocytes in patients with T2D. In vitro data suggest that this effect might not result from a direct effect on mononuclear cells, but rather from indirect systemic mechanisms that warrant further investigation. These findings identify OCN-expressing monocytes as a potential novel therapeutic target for GLP-1 RA to reduce cardiovascular risk in T2D.
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