Tokuda Masaru, Katsuno Tomoyuki, Ochi Fumihiro, Miyakoshi Kana, Kusunoki Yoshiki, Murai Kazuki, Miuchi Masayuki, Hamaguchi Tomoya, Miyagawa Jun-ichiro, Namba Mitsuyoshi
Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan.
Endocr J. 2014;61(4):365-72. doi: 10.1507/endocrj.ej14-0009. Epub 2014 Jan 22.
The effects of exenatide on glycemic control, lipid metabolism, blood pressure, and gastrointestinal symptoms were investigated in obese Japanese patients with type 2 diabetes mellitus. Twenty-six outpatients were enrolled and administered 5 μg of exenatide twice daily. If there was insufficient weight loss and/or insufficient improvement in glycemic control, the dose was increased to 10 μg twice daily. Follow-up was continued until the 12th week of administration. Hemoglobin A1c, glycoalbumin, fasting plasma glucose, body weight, fasting serum C-peptide, serum lipids, blood pressure, and pulse rate were measured before and after the observation period. In the initial phase of exenatide therapy, each patient received a diary to record gastrointestinal symptoms. During treatment with exenatide, hemoglobin A1c decreased significantly and serum C-peptide increased significantly. Body weight, low-density lipoprotein cholesterol, and systolic blood pressure decreased significantly. Nausea was the most frequent gastrointestinal symptom and occurred in 16 patients. Its onset was noted at a mean of 1.7 h after injection, the mean duration was 1.1 h, and it continued for a mean of 9.3 days after the initiation of administration. Patients with nausea showed a significant decrease in hemoglobin Alc, glycoalbumin, or body weight compared with those without nausea. These findings suggest that a more marked improvement in metabolic parameters by exenatide can be partly dependent on the manifestation of gastrointestinal symptoms.
在肥胖的日本2型糖尿病患者中研究了艾塞那肽对血糖控制、脂质代谢、血压和胃肠道症状的影响。招募了26名门诊患者，每天两次给予5μg艾塞那肽。如果体重减轻不足和/或血糖控制改善不足，则将剂量增加至每天两次10μg。随访持续至给药第12周。在观察期前后测量糖化血红蛋白、糖化白蛋白、空腹血糖、体重、空腹血清C肽、血脂、血压和脉搏率。在艾塞那肽治疗的初始阶段，每位患者都收到一本日记以记录胃肠道症状。在使用艾塞那肽治疗期间，糖化血红蛋白显著降低，血清C肽显著增加。体重、低密度脂蛋白胆固醇和收缩压显著降低。恶心是最常见的胃肠道症状，16名患者出现恶心。其发作平均在注射后1.7小时被注意到，平均持续时间为1.1小时，给药开始后平均持续9.3天。与无恶心的患者相比，有恶心的患者糖化血红蛋白、糖化白蛋白或体重显著降低。这些发现表明，艾塞那肽对代谢参数的更显著改善可能部分取决于胃肠道症状的表现。
