Li Shi1, Jing Zhu2, Ping Yang3, Xiaoqiang Tang4, Wenlong Yu5, Changjie Pan6, Moyu Shen7, Dalong Zhu8, Jinluo Cheng9, Xinhua Ye10. 1. Department of Endocrinology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: shili1204@sina.com. 2. Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China. Electronic address: daitoudainaozj@sina.com. 3. Department of Endocrinology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: 13815039666@163.com. 4. Department of Radiology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: txq01040005@163.com. 5. Department of Endocrinology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: wenlongyuwenlong@126.com. 6. Department of Radiology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: pcj424815@sina.com. 7. Department of Endocrinology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: czshenmy@126.com. 8. Department of Endocrinology, The Affiliated Drum Tower Hospital of Nanjing Medical University, No. 321 Zhongshan Road, Nanjing, Jiangsu 210008, China. Electronic address: zhudalong@nju.edu.cn. 9. Department of Endocrinology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: chengjinluo567@sina.com. 10. Department of Endocrinology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: 0818yezi@163.com.
Abstract
OBJECTIVE: To investigate exenatide, a GLP-1 analogue, compared with acarbose, for intra-abdominal fat reduction in patients with obesity and type-2 diabetes. METHODS: This randomized controlled trial included 36 patients with obesity and type-2 diabetes, who were metformin-unresponsive, receivingmetformin/exenatide (GLP-1 group) or metformin/acarbose (control group) for 3 months. Primary end-point: intra-abdominal fat content from baseline to 3 months; Secondary end-points: changes in fasting blood glucose, glycated haemoglobin (HbAlc), fasting insulin, blood lipids, weight, body mass index, and inflammatory cytokines from baseline to 3 months. RESULTS:Intra-abdominal fat content decreased in the GLP-1 group from baseline to 3 months (17,947±5804; 13,717±3628mm2, P=0.001, respectively), but was not significantly reduced in the control group (P=0.197) and at 3 months post-treatment, it was significantly lower in the GLP-1 group than control group (P=0.043). Glucose control, measured by HbA1c (GLP-1: 9.72±1.38; 7.09±0.60%, P<0.001, 9.46±1.25; 7.42±0.84%, P<0.001, respectively) and insulin resistance index LN(HOMA-IR) (GLP-1: 1.58±0.40; 1.01±0.33, P<0.001, Control: 1.53±0.57; 1.10±0.33, P=0.003, respectively) significantly improved in both groups with no significant difference between them. TNF-α, IL-6, and leptin were lower and adiponectin levels higher in the GLP-1 group at 3 months compared with baseline (all P<0.05), but not significantly changed in the control group. TNF-α, IL-6 and leptin levels were similar between groups. Adiponectin level was higher in the GLP-1 group than the control group at 3 months (P=0.025). CONCLUSION:Combined exenatide/metformin reduced intra-abdominal fat content, and enhanced insulin resistance and inflammatory status in patients with obesity and type-2 diabetes, representing a novel treatment regimen.
RCT Entities:
OBJECTIVE: To investigate exenatide, a GLP-1 analogue, compared with acarbose, for intra-abdominal fat reduction in patients with obesity and type-2 diabetes. METHODS: This randomized controlled trial included 36 patients with obesity and type-2 diabetes, who were metformin-unresponsive, receiving metformin/exenatide (GLP-1 group) or metformin/acarbose (control group) for 3 months. Primary end-point: intra-abdominal fat content from baseline to 3 months; Secondary end-points: changes in fasting blood glucose, glycated haemoglobin (HbAlc), fasting insulin, blood lipids, weight, body mass index, and inflammatory cytokines from baseline to 3 months. RESULTS: Intra-abdominal fat content decreased in the GLP-1 group from baseline to 3 months (17,947±5804; 13,717±3628mm2, P=0.001, respectively), but was not significantly reduced in the control group (P=0.197) and at 3 months post-treatment, it was significantly lower in the GLP-1 group than control group (P=0.043). Glucose control, measured by HbA1c (GLP-1: 9.72±1.38; 7.09±0.60%, P<0.001, 9.46±1.25; 7.42±0.84%, P<0.001, respectively) and insulin resistance index LN(HOMA-IR) (GLP-1: 1.58±0.40; 1.01±0.33, P<0.001, Control: 1.53±0.57; 1.10±0.33, P=0.003, respectively) significantly improved in both groups with no significant difference between them. TNF-α, IL-6, and leptin were lower and adiponectin levels higher in the GLP-1 group at 3 months compared with baseline (all P<0.05), but not significantly changed in the control group. TNF-α, IL-6 and leptin levels were similar between groups. Adiponectin level was higher in the GLP-1 group than the control group at 3 months (P=0.025). CONCLUSION: Combined exenatide/metformin reduced intra-abdominal fat content, and enhanced insulin resistance and inflammatory status in patients with obesity and type-2 diabetes, representing a novel treatment regimen.
Authors: Maurice B Bizino; Ingrid M Jazet; Paul de Heer; Huub J van Eyk; Ilona A Dekkers; Patrick C N Rensen; Elisabeth H M Paiman; Hildebrandus J Lamb; Johannes W Smit Journal: Diabetologia Date: 2019-11-05 Impact factor: 10.122