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艾塞那肽治疗可减小甲状腺体积,但对甲状腺结节大小无影响。

EXENATIDE TREATMENT REDUCES THYROID GLAND VOLUME, BUT HAS NO EFFECT ON THE SIZE OF THYROID NODULES.

作者信息

Köseoğlu D, Özdemir Başer Ö, Berker D, Güler S

机构信息

Erol Olçok Education and Research Hospital, Dept. of Endocrinology and Metabolism, Çorum, Turkey.

Yozgat State Hospital, Dept. of Endocrinology and Metabolism, Yozgat, Turkey.

出版信息

Acta Endocrinol (Buchar). 2020 Jul-Sep;16(3):275-279. doi: 10.4183/aeb.2020.275.

Abstract

CONTEXT

Exenatide is a Glucagon-like Peptide-1 receptor agonist, which is widely used for type 2 diabetes mellitus (T2DM). Limited and conflicting results are present about the effect of exenatide on the thyroid gland.

OBJECTIVE

The aim of this study was to evaluate the effect of exenatide treatment on structural and functional features of the thyroid gland in patients with T2DM.

DESIGN

The study was a prospective study, performed between 2015 and 2017. The laboratory values and thyroid ultrasonography features were compared before and after exenatide treatment.

SUBJECTS AND METHODS

The study included 39 obese diabetic patients. After inclusion to the study exenatide was started and patients were followed up for 6 months. Total thyroid volume, thyroid function tests, serum carcinoembryonic antigen (CEA) and calcitonin levels, the size and appearance of thyroid nodules were compared between baseline and after 6 months of treatment.

RESULTS

Exenatide at a dose of 5μg bid was started, increased to 10 μg bid after 4 weeks. We found a statistically significant decrease in thyroid volume (p=0.043) and serum thyroid stimulating hormone (TSH) levels (p=0.007), whereas serum ATPO. ATGl, fT4, fT3, CEA and calcitonin levels did no change with 6 months of exenatide treatment. There were no significant differences in the size and appearance of the thyroid nodules with treatment. The thyroid volume decrease was not correlated with TSH, body mass index and HbA1c reduction.

CONCLUSION

Exenatide treatment for 6 months decreased serum TSH levels and thyroid volume, but had no effect on thyroid nodules and serum CEA and calcitonin levels.

摘要

背景

艾塞那肽是一种胰高血糖素样肽-1受体激动剂,广泛用于2型糖尿病(T2DM)。关于艾塞那肽对甲状腺的影响,目前存在有限且相互矛盾的结果。

目的

本研究旨在评估艾塞那肽治疗对T2DM患者甲状腺结构和功能特征的影响。

设计

该研究为前瞻性研究,于2015年至2017年进行。比较了艾塞那肽治疗前后的实验室检查值和甲状腺超声特征。

研究对象和方法

该研究纳入了39例肥胖糖尿病患者。纳入研究后开始使用艾塞那肽,并对患者进行6个月的随访。比较了基线和治疗6个月后甲状腺总体积、甲状腺功能检查、血清癌胚抗原(CEA)和降钙素水平、甲状腺结节的大小和外观。

结果

开始使用剂量为5μg bid的艾塞那肽,4周后增加至10μg bid。我们发现甲状腺体积(p=0.043)和血清促甲状腺激素(TSH)水平(p=0.007)有统计学意义的下降,而血清抗甲状腺过氧化物酶抗体(ATPO)、抗甲状腺球蛋白抗体(ATGl)、游离甲状腺素(fT4)、游离三碘甲状腺原氨酸(fT3)、CEA和降钙素水平在艾塞那肽治疗6个月后没有变化。治疗后甲状腺结节的大小和外观没有显著差异。甲状腺体积的减少与TSH、体重指数和糖化血红蛋白(HbA1c)的降低无关。

结论

艾塞那肽治疗6个月可降低血清TSH水平和甲状腺体积,但对甲状腺结节以及血清CEA和降钙素水平没有影响。

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Exenatide: pharmacokinetics, clinical use, and future directions.艾塞那肽:药代动力学、临床应用及未来方向。
Expert Opin Pharmacother. 2017 Apr;18(6):555-571. doi: 10.1080/14656566.2017.1282463. Epub 2017 Mar 22.
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GLP-1R agonist therapy for diabetes: benefits and potential risks.GLP-1R 激动剂治疗糖尿病:获益与潜在风险。
Curr Opin Endocrinol Diabetes Obes. 2013 Apr;20(2):87-97. doi: 10.1097/MED.0b013e32835edb32.

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