Abstract
AIMS: Emerging evidence suggested that liraglutide possessed the potential to improve the albumin-to-creatinine ratio (ACR) in patients with type 2 diabetes mellitus (T2DM). This study aimed to ascertain the impact of liraglutide on ACR in T2DM. METHODS: PubMed, Embase, the Cochrane Library, WanFang and CNKI were searched for randomized controlled trials (RCTs) from inception to November 30, 2024 (PROSPERO: CRD52025336785). The data were pooled using fixed- or random-effects models based on the heterogeneity. Sensitivity analyses and publication bias assessments were performed. RESULTS: Seven RCTs involving 473 participants were included. Liraglutide significantly reduced ACR (WMD: - 11.76 mg/g, 95% CI, - 21.71 to - 1.81, I(2) = 75%, P = 0.02) compared to controls (placebo or active drugs). Subgroup analysis revealed significant ACR reductions in patients with HbA1c > 8.0%, follow-up > 12 weeks, and age < 60 years. Meta regression indicated that heterogeneity was not influenced by sample size, HbA1c, baseline ACR, treatment duration, or liraglutide dosage (P = 0.92; 95% CI, - 322.34 to 340.66). The results were stable based in sensitivity analysis, and no publication bias was detected (Begg's P = 0.46; Egger's P = 0.57). CONCLUSIONS: Liraglutide significantly reduced ACR in T2DM, particularly in patients with poor glycemic control, longer treatment duration, and younger age. Future studies with extended follow-up are needed to confirm its renoprotective benefits.