Exenatide was also reported to prevent obesity-induced mitochondrial dysfunction via activating SIRT1-PGC-1α signaling, and therefore ameliorating mitochondrial membrane potential decrease, suppressing mitochondrial ROS production and decreasing cell apoptosis in renal tubular epithelial cells both in vitro and in vivo [321]. This evidence concerns the gene PPARGC1A and obesity due to melanocortin 4 receptor deficiency.