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Benefits of exenatide on obesity and non‐alcoholic fatty liver disease with elevated liver enzymes in patients with type 2 diabetes
Author(s) -
Shao Ning,
Kuang Hong Yu,
Hao Ming,
Gao Xin Yuan,
Lin Wen Jian,
Zou Wei
Publication year - 2014
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2561
Subject(s) - exenatide , medicine , fatty liver , endocrinology , insulin glargine , insulin , type 2 diabetes , triglyceride , gastroenterology , postprandial , diabetes mellitus , hypoglycemia , cholesterol , disease
Background The purpose of this study was to evaluate the advantages of exenatide treatment on obesity and non‐alcoholic fatty liver disease (NAFLD) with elevated liver enzymes in patients with type 2 diabetes (T2D). Methods A total of 60 newly diagnosed patients with obesity, NAFLD with elevated liver enzymes and T2D were included in the study. The patients were randomly divided into two groups. The exenatide treatment group ( n = 30) were treated with exenatide and insulin glargine, and the intensive insulin therapy group ( n = 30) were treated with insulin aspart and insulin glargine for 12 weeks. Selected clinical characteristics were determined, and ultrasonography was performed at both baseline and 12 weeks following treatment. Results At baseline, the clinical characteristics were matched between the two groups. After 12 weeks, fasting blood glucose (FBG), postprandial blood glucose (PBG), glycosylated haemoglobin (HbA 1c ), total cholesterol (TC), triglyceride (TG) and total bilirubin levels were significantly decreased in the two groups ( p < 0.001). Body weight and waist circumference were significantly decreased in the exenatide group but increased in the intensive insulin group ( p < 0.001). The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ ‐glutamyl transpeptidase ( γ GGT) in the exenatide group were significantly lower than in the intensive insulin group ( p < 0.001). The mean body weight change correlated with the levels of ALT, AST and γ GGT change (ALT, r = 0.761; AST, r = 0.733; γ GGT, r = 0.752; p < 0.001). Moreover, the reversal rate of fatty liver was significantly higher in the exenatide group (93.3%) than the intensive insulin group (66.7%) ( p < 0.01). Conclusions Exenatide has a better hepatic–protective effect than intensive insulin therapy and perhaps represents a unique option for adjunctive therapy for patients with obesity, non‐alcoholic fatty liver disease with elevated liver enzymes and T2D. Copyright © 2014 John Wiley & Sons, Ltd.