Yin Ting-Ting, Bi Yan, Li Ping, Shen Shan-Mei, Wang Wei-Min, Jiang Can, Gao Cai-Xia, Wang Yan, Gao Li-Jun, Zhu Da-Long, Feng Wen-Huan
Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China.
2Department of Endocrinology, Drum Tower Clinical Hospital, Medical School of Southeast University, Zhongshan Road 321, Nanjing, 210008 China.
Nutr Metab (Lond). 2018 Oct 1;15:67. doi: 10.1186/s12986-018-0295-6. eCollection 2018.
Weight loss, especially fat mass reduction, helps to improve blood glucose control, insulin sensitivity, and β-cell function. This study aimed to compare the effect of exenatide and glargine on body composition in overweight and obese patients with type 2 diabetes (T2DM) who do not achieve adequate glycemic control with metformin.
We performed a prospective, randomized study of 37 overweight or obese patients with T2DM who had inadequate glycemic control with metformin. The patients were treated with either exenatide or glargine for 16 weeks. Dual-energy X-ray absorptiometry was used to assess body composition.
Post-intervention weight, body mass index (BMI), waist circumference, body mass, and fat mass were lower in patients treated with exenatide, while weight and BMI significantly increased with glargine. Reductions in weight, BMI, body fat mass, and percent fat mass (except for gynoid) were greater with exenatide than with glargine, and percent lean tissue (other than the limbs) increased with exenatide. In all body regions except for the limbs, fat mass decreased with exenatide to a greater extent than lean tissue. Glucose control, insulin resistance, and β-cell function were not different between the treatment groups.
For overweight and obese patients whose T2DM was inadequately controlled with metformin, exenatide and glargine achieved similar improvements in glycemic control, insulin sensitivity, and β-cell function.However, exenatide produced better weight and fat mass reduction, which were beneficial for blood glucose control. Our findings may guide the selection of appropriate drugs for glycemic and weight control.
NCT02325960, registered 25 December 2014.
体重减轻，尤其是脂肪量减少，有助于改善血糖控制、胰岛素敏感性和β细胞功能。本研究旨在比较艾塞那肽和甘精胰岛素对二甲双胍治疗血糖控制不佳的超重和肥胖2型糖尿病（T2DM）患者身体成分的影响。
我们对37例二甲双胍治疗血糖控制不佳的超重或肥胖T2DM患者进行了一项前瞻性随机研究。患者接受艾塞那肽或甘精胰岛素治疗16周。采用双能X线吸收法评估身体成分。
艾塞那肽治疗的患者干预后体重、体重指数（BMI）、腰围、体重和脂肪量降低，而甘精胰岛素治疗后体重和BMI显著增加。艾塞那肽组体重、BMI、体脂肪量和脂肪百分比（除臀区外）的降低幅度大于甘精胰岛素组，艾塞那肽组瘦组织百分比（四肢除外）增加。除四肢外，艾塞那肽治疗后所有身体部位的脂肪量减少幅度均大于瘦组织。治疗组之间的血糖控制、胰岛素抵抗和β细胞功能无差异。
对于二甲双胍治疗血糖控制不佳的超重和肥胖患者，艾塞那肽和甘精胰岛素在血糖控制、胰岛素敏感性和β细胞功能方面取得了相似的改善。然而，艾塞那肽在减轻体重和脂肪量方面效果更好，这有利于血糖控制。我们的研究结果可能为血糖和体重控制药物的选择提供指导。
NCT02325960，2014年12月25日注册。
