Effect of exenatide treatment on visceral fat and early renal injury in overweight/obese T2DM patients

Qiao QIAO; Jing XU; Jian WANG; Hongting ZHENG; Qiang TONG; Qian BAI; Yuan YUAN

doi:10.16016/j.1000-5404.201807188

您当前的位置：

首页 >

文章列表页 >

Effect of exenatide treatment on visceral fat and early renal injury in overweight/obese T2DM patients

Clinical Medicine | 更新时间：2026-01-09

- Effect of exenatide treatment on visceral fat and early renal injury in overweight/obese T2DM patients
- Journal of Third Military Medical University Vol. 40, Issue 20, Pages: 1883-1888(2018)
- 作者机构：
  
  1.400037 重庆，陆军军医大学(第三军医大学)第二附属医院：内分泌科
  2.400037 重庆，陆军军医大学(第三军医大学)第二附属医院：营养科
- 作者简介：
- 基金信息：
  
  the Science and Technology Innovation Special Project of Social Undertakings and People 's Livelihood Security of Chongqing(CTSTC2015shmszx120014);the Integrated Demonstration Plan of Chongqing(CSTC2015jcsf10003);the Clinical Scientific Research Project of Second Affiliated Hospital of Third Military Medical University(2014YLC20)
- DOI：10.16016/j.1000-5404.201807188
  CLC： R587.1;R589.2;R977.15
- Received：26 July 2018，
  
  Revised：2018-09-10，
  
  Published：30 October 2018
- 稿件说明：
移动端阅览
Qiao QIAO, Jing XU, Jian WANG, et al. Effect of exenatide treatment on visceral fat and early renal injury in overweight/obese T2DM patients[J]. Journal of Third Military Medical University, 2018, 40(20): 1883-1888.
DOI：

Qiao QIAO, Jing XU, Jian WANG, et al. Effect of exenatide treatment on visceral fat and early renal injury in overweight/obese T2DM patients[J]. Journal of Third Military Medical University, 2018, 40(20): 1883-1888. DOI： 10.16016/j.1000-5404.201807188.

摘要

目的

探讨艾塞那肽对超重/肥胖的2型糖尿病(type 2 diabetes mellitus，T

DM)患者的微量白蛋白尿(microalbuminuria，MAU)排泄及与内脏脂肪面积(visceral fat area，VFA)、体质指数(body mass index，BMI)、腰臀比(waist-to-hip ratio，WHR)的关系及影响。

方法

收集本科2015年1月至2016年6月就诊的符合标准的超重/肥胖的2型糖尿病患者76例，按简单随机化原则分成两组，在原口服降糖方案血糖控制不佳基础上，艾塞那肽组接受艾塞那肽注射液皮下注射，每日2次，对照组采用甘精胰岛素，每日1次，整个治疗共计24周。观察两组患者治疗前后MAU、VFA、BMI、WHR、空腹血糖(fasting blood glucose，FBG)、糖化血红蛋白(glycated hemoglobin，HbA1c)的变化，并进行相关分析。

结果

艾塞那肽组患者在治疗12周和24周后的MAU、VFA、BMI、WHR、FBG、HbA1c较治疗前明显下降(

0.05)，而对照组仅有BMI、FBG和HbA1c呈现明显下降(

0.05)。艾塞那肽组VFA、BMI、WHR、MAU的变化与FBG、HbA1c的变化呈显著正相关(

0.05)。

结论

艾塞那肽可显著降低超重/肥胖的2型糖尿病患者的MAU排泄、血糖和体脂水平，且MAU排泄下降同VFA、BMI、WHR、血糖的降低密切相关。

Abstract

Objective

To investigate the relationship and effect of exenatide on microalbuminuria (MAU)

visceral fat area (VFA)

body mass index (BMI)

and waist-to-hip ratio (WHR) in overweight/obese patients with type 2 diabetes mellitus (T2DM).

Methods

A total of 77 overweight/obese T2DM patients who met our criteria and admitted in our hospital from January 2015 to June 2016 were enrolled in this study. They were randomly divided into exenatide group and control group. Since their poor glycemic control by original oral hypoglycemic protocol

exenatide injection was given subcutaneously to the former group twice a day

and insulin glargine injection to the latter group

once a day for a total of 24 weeks. The changes of MAU

VFA

BMI

WHR

fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) were observed before and after treatment in the 2 groups

and the correlation analysis was made.

Results

The levels of MAU

VFA

BMI

WHR

PBG and HbA1c were significantly decreased in the exenatide group after 12 and 24 weeks' treatment (

.05). In the exenatide group

the changes of MAU

VFA

BMI and WHR were positively correlated with those of PBG and HbA1c (

0.05)

while such differences were only found in the levels of BMI

PBG and HbA1c in the control group (

0.05). In the exenatide group

the changes of MAU

VFA

BMI and WHR were positively correlated with those of PBG and HbA1c (

0.05).

Conclusions

Exenatide obviously reduces MAU

obesity and blood glucose in overweight/obese T2DM patients

and the excretion of MAU is closely associated with the decreases of VFA

WHR

BMI and blood glucose.

关键词

Keywords

references

XU Y, WANG L, HE J, et al. 2010 China Noncommunicable Disease Surveillance Group.Prevalence and eontrol of diabetes in Chinese adults[J]. JAMA, 2013, 310(9): 948-959. DOI: 10.1001/jama.2013.168118.

DE BOER I H, RUE T C, HALL Y N et al. Temporal trends in the prevalence of diabetic kidney disease in the United States [J]. JAMA, 2011, 305(24): 2532-2539. DOI: 10.1001/jama.2011.861.

中华医学会糖尿病学分会微血管并发症学组.糖尿病肾病防治专家共识(2014年版)[J].中国糖尿病杂志, 2014, 6(11): 792-801. DOI: 10.3969/j.issn.1008-8296.2015-05.

The microvascular complications group of Chinese Diabetes Society, Chinese Medical Association. Expert consensus on the prevention and control of diabetic nephropathy (2014)[J]. Chin J Diabetes Mellitus, 2014, 6(11): 792-801. DOI: 10.3969/j.issn.1008-8296.2015-05.

TAPP R J, SHAW J E, ZIMMET P Z, et al. Albuminuria is evident in the early stages of diabetes onset: results from the Australian Diabetes, Obesity, and Lifestyle Study (Aus-Diab) [J]. Am J Kidney Dis, 2004, 44(5): 792-798. DOI: 10.1053/j.ajkd.2004.07.006.

HU J, YANG S, ZHANG A, et al. Abdominal obesity is more closely associated with diabetic kidney disease than general obesity[J]. Diabetes Care, 2016, 39(10): e179-e180. DOI: 10.2337/dc16-1025.

吴敏, 刘芳, 付平.胰高血糖素样肽-1与糖尿病肾病[J].中华肾病杂志, 2011, 27(12): 941-944. DOI: 10.3760/cma.j.issn.1001-7097.2011.12.018.

WU M, LIU F, FU P. Glucagon like peptide -1 and diabetic nephropathy[J]. Chin J Nephrol, 2011, 27(12): 941-944. DOI: 10.3760/cma.j.issn.1001-7097.2011.12.018.

TONG Q, WANG H, GUAN L Z, et al. Clinical effects of exenatide in treatment of type 2 diabetes and on expression of C-peptide[J]. Third Mil Med Univ, 2014, 36(15): 1604-1606.DOI: 10.16016/j.1000-5404.2014.15.015.

KODERA R, SHIKATA K, KATAOKA H, et al. Glucagon-like peptide-1 receptor agonist ameliorates renal injury through its anti-inflammatory action without lowering blood glucose level in a rat model of type diabetes[J]. Diabetologiam, 2011, 54(5): 965-978. DOI: 10.1007/s00125-010-2028-x.

HOU X, LU J, WENG J, et al. Impact of waist circumference and body mass index on risk of cardiometabolic disorder and cardiovascular disease in Chinese adults: a national diabetes and metabolic disorders survey[J]. PLoS ONE, 2013, 8(3): e57319. DOI: 10.1371/journal.pone.0057319.

KANG S H, CHO K H, PARK J W, et al. Association of visceral fat area with chronic kidney disease and metabolic syndrome risk in the general population: analysis using multi-frequency bioimpedance[J]. Kidney Blood Press Res, 2015, 40(3): 223-230. DOI: 10.1159/000368498.

BU J, FENG Q, RAN J, et al. Visceral fat mass is always, but adipokines (adiponectin and resistin) are diversely associated with insulin resistance in Chinese type 2 diabetic and normoglycemic subjects[J]. Diabetes Res Clin Pract, 2012, 96(2): 163-169. DOI: 10.1016/j.diabres.2011.12.014.

SHEPHERD J, KASTELEIN J J, BITTNER V, et al. Effect of intensive lipid lowering with atorvastatin on renal function in patients with coronary heart disease: the treating to new targets (TNT) study[J]. Clin J Am Soc Nephrol, 2007, 2(6): 1131-1139. DOI: 10.2215/CJN.04371206.

GOSMANOV A R, GOSMANOVA E O. Long-term renal outcomes of patients with type 1 diabetes mellitus and microalbuminuria: an analysis of the DCCT/EDIC cohort[J]. Arch Intern Med, 2011, 171(17): 1596. DOI: 10.1001/archinternmed.2011.413.

DOUNOUSI E, DUNI A, LEIVADITIS K, et al. Improvements in the management of diabetic nephropathy[J]. Rev Diabet Stud, 2015, 12(1/2): 119-133. DOI: 10.1900/RDS.2015.12.119.

UK Prospective Diabetes Study (UKPDS) Group.Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes(UKPDS 33)[J]. Lancet, 1998, 352(9131): 837-853. DOI: 10.1016/S0140-6736(98)07019-6.

BLONDE L, PENCEK R, MACCONELL L.Association among weight change, glycemic control, and markers of cardiovascular risk with exenatide once weekly: a pooled analysis of patients with type 2 diabetes[J]. Cardiovasc Diabetol, 2015, 14: 12. DOI: 10.1186/s12933-014-0171-2.

JAMESON K, D'OCA K, LEIGH P, et al. Adherence to NICE guidance on glucagon-like peptide-1 receptor agonists among patients with type 2 diabetes mellitus: an evaluation using the Clinical Practice Research Datalink[J]. Curr Med Res Opin, 2016, 32(1): 49-60. DOI: 10.1185/03007995. 2015.1101372.

SAIKI A, NAGAYAMA D, OHHIRA M, et al. Effect of weight loss using formula diet on renal function in obese patients with diabetic nephropathy[J]. Int J Obes (Lond) 2005, 29(9): 1115-1120. DOI: 10.1038/sj.ijo.0803009.

FORNONI A, IJAZ A, TEJADA T, et al. Role of inflammation in diabetic nephropathy[J]. Curr Diabetes Rev, 2008, 4(1): 10-17. DOI: 10.2174/157339908783502361.

ISHIBASHI Y, NISHINO Y, MATSUI T, et al. Glucagon-like peptide-1 suppresses advanced glycation end product-induced monocyte chemoattractant protein-1 expression in mesangial cells by reducing advanced glycation end product receptor level[J]. Metabolism, 2011, 60(9): 1271-1277. DOI: 10.1016/j.metabol.2011.01.010.

OESEBURG H, DE BOER R A, BUIKEMA H, et al. Glucagon-like peptide 1 prevents reactive oxygen species-induced endothelial cell senescence through the activation of protein kinase A [J]. Arterioscler Thromb Vasc Biol, 2010, 30(7): 1407-1414. DOI: 10.1161/ATVBAHA.110.206425.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Effect of nutritional therapy on body composition in overweight/obese children with systemic lupus erythematosus

Current situation analysis of dietary patterns among middle-aged and elderly with different obesity metabolic phenotypes in Sichuan area

Characteristics of gut microbiota in middle-aged and elderly overweight/obese women based on body composition data

Differences of gutmicrobiota and serum biochemical markers between Tibetan and Han population with different body mass indexes

Apocynum venetum L. extract ameliorates metabolic dysbiosis and intestinal flora disorder induced by high-fat diet in mice

Related Author

杨炯贤

张俊梅

李超

李彩凤

魏瑶瑶

林嘉玲

蒲芳芳

石磊

Related Institution

No data

⁰