Keller Jutta, Trautmann Michael E, Haber Harry, Tham Lai San, Hunt Tamsin, Mace Kenneth, Linnebjerg Helle
Israelitic Hospital, Academic Hospital University of Hamburg, Hamburg, Germany.
Regul Pept. 2012 Nov 10;179(1-3):77-83. doi: 10.1016/j.regpep.2012.08.005. Epub 2012 Sep 6.
Exenatide is a glucagon-like peptide-1 receptor agonist for the treatment of type 2 diabetes and has been shown to lower blood glucose through multiple mechanisms, including glucose-dependent insulin secretion, suppression of postprandial glucagon release and slowing of gastric emptying. The effects of exenatide on biliary motility are unknown. This study evaluated the effect of a single dose of exenatide on cholecystokinin (CCK)-induced gallbladder emptying. Healthy subjects participated in this randomized, 2-period, double-blind crossover study. Fasting subjects received a single subcutaneous injection of exenatide (10 μg) or placebo 60 min before CCK infusion. Gallbladder volume and ejection fraction (EF) were assessed by ultrasonography before, during, and after CCK infusion (0.003 μg/kg infused over 50 min at 2 mL/min). The diameters of the main pancreatic duct and common bile duct were measured sonographically at the same time points before, during, and following CCK infusion. Administration of exenatide did not affect pre-CCK infusion gallbladder volume or EF compared to placebo. During the CCK-infusion, the mean minimum gallbladder volume was similar for exenatide (13.68 mL) and placebo (11.05 mL) (least squares mean [LSM] difference of 2.62 mL; 95% confidence interval [CI], -0.53, 5.78), but the mean maximum EF was lower for exenatide (28.79%) versus placebo (46.13%) (LSM difference of -17.34%; 95% CI, -30.54, -4.13). Exenatide had no clinically significant effects on pancreatic or bile duct diameters. In conclusion, exenatide reduced CCK-induced gallbladder emptying compared with placebo in fasting healthy subjects.
艾塞那肽是一种用于治疗2型糖尿病的胰高血糖素样肽-1受体激动剂，已被证明可通过多种机制降低血糖，包括葡萄糖依赖性胰岛素分泌、抑制餐后胰高血糖素释放以及减缓胃排空。艾塞那肽对胆道运动的影响尚不清楚。本研究评估了单剂量艾塞那肽对胆囊收缩素（CCK）诱导的胆囊排空的影响。健康受试者参与了这项随机、两阶段、双盲交叉研究。空腹受试者在输注CCK前60分钟接受单次皮下注射艾塞那肽（10μg）或安慰剂。在输注CCK期间及之后，通过超声检查评估胆囊体积和射血分数（EF）（以2mL/分钟的速度在50分钟内输注0.003μg/kg）。在输注CCK之前、期间和之后的相同时间点，通过超声测量主胰管和胆总管的直径。与安慰剂相比，给予艾塞那肽不影响输注CCK前的胆囊体积或EF。在输注CCK期间，艾塞那肽组（13.68mL）和安慰剂组（11.05mL）的平均最小胆囊体积相似（最小二乘均值[LSM]差异为2.62mL；95%置信区间[CI]，-0.53，5.78），但艾塞那肽组的平均最大EF（28.79%）低于安慰剂组（46.13%）（LSM差异为-17.34%；95%CI，-30.54，-4.13）。艾塞那肽对胰管或胆管直径无临床显著影响。总之，在空腹健康受试者中，与安慰剂相比，艾塞那肽减少了CCK诱导的胆囊排空。
