Insulin Glargine is More Suitable Than Exenatide in Preventing Muscle Loss in Non-Obese Type 2 Diabetic Patients with NAFLD.

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM Experimental and Clinical Endocrinology & Diabetes Pub Date : 2023-11-01 Epub Date: 2023-07-31 DOI:10.1055/a-2145-1004

Lin Liu, Ruwen Wang, Jian Gao, Jianhua Yan, Jingtian Zhang, Zhitian Zhang, Jiaojiao Liu, Huandong Lin, Shengxiang Rao, Xiuzhong Yao, Weiyun Wu, Hua Bian, Xiangyu Wang, Shanshan Guo, Xin Gao, Hongmei Yan

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Abstract

Aim: This study investigated the effects of insulin glargine and exenatide on the muscle mass of patients with newly diagnosed type 2 diabetes (T2DM) and nonalcoholic fatty liver disease (NAFLD).

Methods: We performed a post-hoc analysis of our previously study, a 24-week randomized controlled multicenter clinical trial (ClinicalTrials.gov, NCT02303730). Seventy-six patients were randomly assigned 1:1 to receive insulin glargine or exenatide treatment. The changes in psoas muscle area (PMA) (mm²) were obtained with the cross-sectional Dixonfat magnetic resonance images at the fourth lumber vertebra.

Results: There were no significant differences in age, BMI, gender, and PMA in insulin glargine and exenatide groups at baseline. After treatment, PMA tended to increase by 13.13 (-215.52, 280.80) mm² in the insulin glargine group and decrease by 149.09 (322.90-56.39) mm² in the exenatide group (both p>0.05). Subgroup analysis showed a 560.64 (77.88, 1043.40) (mm²) increase of PMA in the insulin group relative to the Exenatide group in patients with BMI<28 kg/m² (p0.031) after adjusting for gender, age, and research center. Interaction analysis showed an interaction between BMI and treatment (p0.009). However, no interaction was observed among subgroups with a BMI≥28 kg/m² or with different genders and ages.

Conclusion: Compared to exenatide, insulin glargine can relativity increase PMA in patients with T2DM having BMI<28 kg/m² and NAFLD.

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甘精胰岛素比艾塞那肽更适合预防非肥胖2型糖尿病NAFLD患者的肌肉损失。

目的：本研究探讨甘精胰岛素和艾塞那肽对新诊断的2型糖尿病（T2DM）和非酒精性脂肪肝（NAFLD）患者肌肉质量的影响。方法：我们对之前的研究进行了事后分析，这是一项为期24周的随机对照多中心临床试验（ClinicalTrials.gov，NCT02303730）。76名患者被1:1随机分配接受甘精胰岛素或艾塞那肽治疗。腰大肌面积（PMA）（mm2）的变化是通过第四腰椎的横截面Dixonfat磁共振图像获得的。结果：基线时甘精胰岛素组和艾塞那肽组在年龄、BMI、性别和PMA方面没有显著差异。治疗后，甘精胰岛素组的PMA倾向于增加13.13（-215.52，280.80）mm2，艾塞那肽组减少149.09（322.90-56.39）mm2（均p>0.05）。亚组分析显示，在调整性别、年龄和研究中心后，胰岛素组的BMI2患者的PMA比艾塞那苷组增加560.64（77.88，1043.40）（mm2）（p0.031）。交互作用分析显示BMI和治疗之间存在交互作用（p0.009）。然而，在BMI≥28的亚组之间没有观察到交互作用 kg/m2或不同性别和年龄。结论：与艾塞那肽相比，甘精胰岛素可显著提高伴有BMI2和NAFLD的T2DM患者的PMA。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Experimental and Clinical Endocrinology & Diabetes 医学-内分泌学与代谢

CiteScore

4.10

自引率

5.60%

发文量

审稿时长

3 months

期刊介绍： Publishing outstanding articles from all fields of endocrinology and diabetology, from molecular biology to clinical research, this journal is a brilliant resource. Since being published in English in 1983, the popularity of this journal has grown steadily, reflecting the importance of this publication within its field. Original contributions and short communications appear in each issue along with reviews addressing current topics. In addition, supplementary issues are published each year presenting abstracts or proceedings of national and international scientific meetings. The journal was initially published in German and is still the oldest endocrinological periodical in the German-language market!