DURABILITY OF EFFECTS OF EXENATIDE TREATMENT ON GLYCEMIC CONTROL, BODY WEIGHT, SYSTOLIC BLOOD PRESSURE, C-REACTIVE PROTEIN, AND TRIGLYCERIDE CONCENTRATIONS

被引:33
作者
Varanasi, Ajay
Chaudhuri, Ajay
Dhindsa, Sandeep
Arora, Amita
Lohano, Teekam
Vora, Mehul R.
Dandona, Paresh
机构
[1] SUNY Buffalo, Div Endocrinol Diabet & Metab, Buffalo, NY 14209 USA
[2] Kaleida Hlth, Buffalo, NY USA
关键词
D O I
10.4158/EP10199.OR
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To determine (1) whether long-term treatment with exenatide is associated with reductions in C-reactive protein (CRP), systolic blood pressure (BP), and triglyceride concentrations in addition to reductions in body weight and hemoglobin A(1c) (A1C) levels and (2) whether these beneficial results persist without any loss of effect while exenatide is being used, and whether they reverse after its cessation. Methods: We conducted a retrospective review of 141 patients with type 2 diabetes mellitus treated with exenatide at a tertiary clinic. Results: Exenatide (mean duration of treatment, 1.4 years) decreased A1C (0.7%), weight (5 kg), systolic BP (8 mm Hg), and triglyceride concentrations (46 mg/dL) (P<.05 for all). Sixty-one patients continued exenatide therapy throughout the study (mean duration of use, 2.4 years). Exenatide treatment reduced their mean weight by 7 kg, systolic BP by 8 mm Hg, triglycerides by 52 mg/dL, A1C by 1.3%, and CRP by 2.4 mg/L (P<.05 for all). Reductions in systolic BP and CRP were not related to weight loss. The reduction in CRP concentration was significantly related to the baseline CRP concentration (r = 0.78; P<.001) and to change in A1C (r = 0.68; P = .02). Patients who stopped taking exenatide had a reversal of the benefits within 6 months after cessation of treatment. Conclusion: Exenatide treatment in patients with type 2 diabetes has durable and persistent beneficial effects on A1C, weight, CRP, systolic BP, and triglyceride concentrations. Cessation of treatment reverses all these beneficial effects within 6 months. There was no evidence of loss of its effects while exenatide treatment was continued.
引用
收藏
页码:192 / 200
页数:9
相关论文
共 16 条
[1]   Efficacy and safety of incretin therapy in type 2 diabetes - Systematic review and meta-analysis [J].
Amori, Renee E. ;
Lau, Joseph ;
Pittas, Anastassios G. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2007, 298 (02) :194-206
[2]   Exenatide is Non-inferior to Insulin in Reducing HbA1c : An Integrated Analysis of 1423 Patients with Type 2 Diabetes [J].
Blevins, Thomas ;
Han, Jenny ;
Nicewarner, Dawn ;
Chen, Steve ;
Oliveira, Juliana H. A. ;
Aronoff, Stephen .
POSTGRADUATE MEDICINE, 2010, 122 (03) :118-128
[3]   Metabolic effects of two years of exenatide treatment on diabetes, obesity, and hepatic biomarkers in patients with type 2 diabetes: An interim analysis of data from the open-label, uncontrolled extension of three double-blind, placebo-controlled trials [J].
Buse, John B. ;
Klonoff, David C. ;
Nielsen, Loretta L. ;
Guan, Xuesong ;
Bowlus, Christopher L. ;
Holcombe, John H. ;
Maggs, David G. ;
Wintle, Matthew E. .
CLINICAL THERAPEUTICS, 2007, 29 (01) :139-153
[4]   Mechanism of action of exenatide to reduce postprandial hyperglycemia in type 2 diabetes [J].
Cervera, Antonio ;
Wajcberg, Estela ;
Sriwijitkamol, Apiradee ;
Fernandez, Marianella ;
Zuo, Pengou ;
Triplitt, Curtis ;
Musi, Nicolas ;
DeFronzo, Ralph A. ;
Cersosimo, Eugenio .
AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM, 2008, 294 (05) :E846-E852
[5]   A Novel Antihypertensive Effect of Exenatide, a GLP-1 Agonist [J].
Dandona, Paresh ;
Chaudhuri, Ajay ;
Dhindsa, Sandip .
AMERICAN JOURNAL OF HYPERTENSION, 2010, 23 (03) :228-228
[6]   Effect on glycemic control of exenatide (synthetic exendin-4) additive to existing metformin and/or sulfonylurea treatment in patients with type 2 diabetes [J].
Fineman, MS ;
Bicsak, TA ;
Shen, LZ ;
Taylor, K ;
Gaines, E ;
Varns, A ;
Kim, D ;
Baron, AD .
DIABETES CARE, 2003, 26 (08) :2370-2377
[7]   Effect of exenatide on heart rate and blood pressure in subjects with type 2 diabetes mellitus: a double-blind, placebo-controlled, randomized pilot study [J].
Gill, Anne ;
Hoogwerf, Byron J. ;
Burger, Jude ;
Bruce, Simon ;
MacConell, Leigh ;
Yan, Ping ;
Braun, Daniel ;
Giaconia, Joseph ;
Malone, James .
CARDIOVASCULAR DIABETOLOGY, 2010, 9
[8]  
Heine RJ, 2005, ANN INTERN MED, V143, P559, DOI 10.7326/0003-4819-143-8-200510180-00006
[9]   Exendin-4 has an anti-hypertensive effect in salt-sensitive mice model [J].
Hirata, Kunio ;
Kume, Shinji ;
Araki, Shin-ichi ;
Sakaguchi, Masayoshi ;
Chin-Kanasaki, Masami ;
Isshiki, Keiji ;
Sugimoto, Toshiro ;
Nishiyama, Akira ;
Koya, Daisuke ;
Haneda, Masakazu ;
Kashiwagi, Atsunori ;
Uzu, Takashi .
BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS, 2009, 380 (01) :44-49
[10]   Improvement of Postprandial Endothelial Function After a Single Dose of Exenatide in Individuals With Impaired Glucose Tolerance and Recent-Onset Type 2 Diabetes [J].
Koska, Juraj ;
Schwartz, Eric A. ;
Mullin, Michael P. ;
Schwenke, Dawn C. ;
Reaven, Peter D. .
DIABETES CARE, 2010, 33 (05) :1028-1030