Exenatide improves type 2 diabetes concomitant with non-alcoholic fatty liver disease.

OBJECTIVE To investigate the effects of exenatide on blood glucose, body weight and hepatic enzymes in patients with type 2 diabetes mellitus (T2DM) and concomitant non-alcoholic fatty liver disease (NAFLD). SUBJECTS AND METHODS One hundred and seventeen patients with T2DM and NAFLD were randomly divided into exenatide group and metformin group. Patients were treated with exenatide and metformin, respectively, for 12 weeks. RESULTS After 12 weeks of treatment, body weight, body mass index (BMI), waist-to-hip ratio, HbA1c, FPG, 2-h PPG, ALT, AST, γ-GT, and hs-CRP were significantly reduced, and the AST/ALT ratio and adiponectin were markedly increased in both groups. BMI, waist-to-hip ratio, 2-h PPG, ALT, AST, γ-GT, and hs-CRP were markedly lower, and AST/ALT ratio and adiponectin in the exenatide group were dramatically higher than in the metformin group. CONCLUSION Compared with metformin, exenatide is better to control blood glucose, reduces body weight and improves hepatic enzymes, attenuating NAFLD in patients with T2DM concomitant with NAFLD.

[1]  M. Fuchs,et al.  The cardiovascular link to nonalcoholic fatty liver disease: a critical analysis. , 2012, Clinics in liver disease.

[2]  M. Vivarelli,et al.  Glucagon‐like peptide‐1 receptor activation stimulates hepatic lipid oxidation and restores hepatic signalling alteration induced by a high‐fat diet in nonalcoholic steatohepatitis , 2011, Liver international : official journal of the International Association for the Study of the Liver.

[3]  K. Clément,et al.  C-reactive protein levels in relation to various features of non-alcoholic fatty liver disease among obese patients. , 2011, Journal of hepatology.

[4]  M. Rinella,et al.  The role of insulin-sensitizing agents in the treatment of nonalcoholic steatohepatitis , 2011, Therapeutic advances in gastroenterology.

[5]  M. Birnbaum,et al.  Insulin signaling to hepatic lipid metabolism in health and disease , 2011, Critical reviews in biochemistry and molecular biology.

[6]  B. Gallwitz.  This material is the copyright of the original publisher. Unauthorised copying and distribution is prohibited. Glucagon-like Peptide-1 Analogues for Type 2 Diabetes Mellitus Current and Emerging Agents , 2011 .

[7]  D. Harnois,et al.  Risk of Cardiovascular Disease in Patients with Nonalcoholic Fatty Liver Disease , 2011 .

[8]  G. Musso,et al.  A meta‐analysis of randomized trials for the treatment of nonalcoholic fatty liver disease , 2010, Hepatology.

[9]  M. Taskinen,et al.  Exenatide Affects Circulating Cardiovascular Risk Biomarkers Independently of Changes in Body Composition , 2010, Diabetes Care.

[10]  Wenying Yang,et al.  Prevalence of diabetes among men and women in China. , 2010, The New England journal of medicine.

[11]  K. Cusi,et al.  New diagnostic and treatment approaches in non-alcoholic fatty liver disease (NAFLD) , 2009, Annals of medicine.

[12]  S. Assimakopoulos,et al.  Serum adiponectin levels in different types of non alcoholic liver disease. Correlation with steatosis, necroinflammation and fibrosis. , 2008, Acta gastro-enterologica Belgica.

[13]  D. Klonoff,et al.  Exenatide effects on diabetes, obesity, cardiovascular risk factors and hepatic biomarkers in patients with type 2 diabetes treated for at least 3 years. , 2008, Current medical research and opinion.

[14]  R. Merriman,et al.  Medical treatment of non-alcoholic steatohepatitis. , 2007, Clinics in liver disease.

[15]  Fernando Costa,et al.  Primary Prevention of Cardiovascular Diseases in People With Diabetes Mellitus , 2007, Diabetes Care.

[16]  S. Grundy,et al.  Primary Prevention of Cardiovascular Diseases in People With Diabetes Mellitus , 2006, Diabetes Care.

[17]  Michaela Diamant,et al.  Alanine aminotransferase as a marker of non‐alcoholic fatty liver disease in relation to type 2 diabetes mellitus and cardiovascular disease , 2006, Diabetes/metabolism research and reviews.

[18]  F. Anania,et al.  Exendin‐4, a glucagon‐like protein‐1 (GLP‐1) receptor agonist, reverses hepatic steatosis in ob/ob mice , 2006, Hepatology.

[19]  S. Haffner,et al.  Liver markers and development of the metabolic syndrome: the insulin resistance atherosclerosis study. , 2005, Diabetes.

[20]  H. Conjeevaram,et al.  One-Year Intense Nutritional Counseling Results in Histological Improvement in Patients with Nonalcoholic Steatohepatitis: A Pilot Study , 2005, The American Journal of Gastroenterology.

[21]  David A. Sass,et al.  Nonalcoholic Fatty Liver Disease: A Clinical Review , 2005, Digestive Diseases and Sciences.

[22]  G. Bray,et al.  0021-972X/04/$15.00/0 The Journal of Clinical Endocrinology & Metabolism 89(6):2583–2589 Printed in U.S.A. Copyright © 2004 by The Endocrine Society doi: 10.1210/jc.2004-0535 Medical Consequences of Obesity , 2022 .

[23]  R. Koretz,et al.  Is weight reduction an effective therapy for nonalcoholic fatty liver? A systematic review. , 2003, The American journal of medicine.

[24]  A. Mokdad,et al.  Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. , 2003, JAMA.

[25]  American Gastroenterological Association medical position statement: nonalcoholic fatty liver disease. , 2002, Gastroenterology.

[26]  C. Boland,et al.  American Gastroenterological Association. Our new president--Jon I. Isenberg, M.D. , 2001, Gastroenterology.

[27]  J. Raufman,et al.  Isolation and characterization of exendin-4, an exendin-3 analogue, from Heloderma suspectum venom. Further evidence for an exendin receptor on dispersed acini from guinea pig pancreas. , 1992, The Journal of biological chemistry.