Guclu Metin, Kiyici Sinem, Gul Zulfiye, Cavun Sinan
Health Sciences UniversityBursa Yuksek Ihtisas Education and Training Hospital, Department of Endocrinology and Metabolism, Bursa, Turkey.
Health Sciences UniversityBursa Yuksek Ihtisas Education and Training Hospital, Department of Endocrinology and Metabolism, Bursa, Turkey
Endocr Connect. 2018 Jan;7(1):193-198. doi: 10.1530/EC-17-0242. Epub 2017 Dec 7.
In the present study, we investigated the long-term effects of exenatide treatment on serum fasting ghrelin levels in patients with type 2 diabetes mellitus.
Type 2 diabetic patients, who were using metformin with and without the other antihyperglycemic drugs on a stable dose for at least 3 months, were enrolled in the study. BMI>35 kg/m and HbA1c>7.0% were the additional inclusion criteria. Oral antihyperglycemic drugs, other than metformin, were stopped, and metformin treatment was continued at 2000 mg per day. Exenatide treatment was initiated at 5 µg per dose subcutaneously (sc) twice daily, and after one month, the dose of exenatide was increased to 10 µg twice daily. Changes in anthropometric variables, glycemic control, lipid parameters and total ghrelin levels were evaluated at baseline and following 12 weeks of treatment.
Thirty-eight patients (male/female = 7/31) entered the study. The mean age of patients was 50.5 ± 8.8 years with a mean diabetes duration of 8.5 ± 4.9 years. The mean BMI was 41.6 ± 6.3 kg/m and the mean HbA1c of patients was 8.9 ± 1.4%. The mean change in the weight of patients was -5.6 kg and the percentage change in weight was -5.2 ± 3.7% following 12 weeks of treatment. BMI, fasting plasma glucose and HbA1c levels of patients were decreased significantly ( < 0.001 and < 0.001; respectively), while there was no change in lipid parameters. Serum fasting ghrelin levels were significantly suppressed following 12 weeks of exenatide treatment compared with baseline values (328.4 ± 166.8 vs 245.3 ± 164.8 pg/mL) ( = 0.024).
These results suggest that the effects of exenatide on weight loss may be related with the suppression of serum fasting ghrelin levels, which is an orexigenic peptide.
在本研究中，我们调查了艾塞那肽治疗对2型糖尿病患者血清空腹胃饥饿素水平的长期影响。
纳入至少3个月稳定使用二甲双胍（无论是否联用其他降糖药物）的2型糖尿病患者。额外纳入标准为BMI>35kg/m²且HbA1c>7.0%。停用二甲双胍以外的口服降糖药物，继续每日2000mg二甲双胍治疗。开始皮下注射艾塞那肽，剂量为5μg/次，每日2次，1个月后，艾塞那肽剂量增至10μg，每日2次。在基线及治疗12周后评估人体测量学变量、血糖控制、血脂参数及总胃饥饿素水平的变化。
38例患者（男/女=7/31）进入研究。患者平均年龄为50.5±8.8岁，平均糖尿病病程为8.5±4.9年。平均BMI为41.6±6.3kg/m²，患者平均HbA1c为8.9±1.4%。治疗12周后患者体重平均变化为-5.6kg，体重变化百分比为-5.2±3.7%。患者的BMI、空腹血糖和HbA1c水平显著降低（分别为P<0.001和P<0.001），而血脂参数无变化。与基线值相比，艾塞那肽治疗12周后血清空腹胃饥饿素水平显著降低（328.4±166.8 vs 245.3±164.8pg/mL）（P=0.024）。
这些结果表明，艾塞那肽的减肥作用可能与抑制血清空腹胃饥饿素水平有关，胃饥饿素是一种促食欲肽。
