关键词: 艾塞那肽；2型糖尿病； nesfatin-1；肝脏脂肪含量；磁共振波谱学

Abstract:

Objective   To compare the change of serum nesfatin-1, liver fat contents (LFC), carbohydrate and lipid metabolism in obese patients with type 2 diabetes mellitus before and after the treatment with exenatide. Methods   The trial adopted a self-controlling methods.15 patients with T2DM who were unable to achieve glycemic control with insulin and(or) oral antidiabetes agents for at least 3 month, were treated with exenatide. Levels of indicators such as weight, waist circumference, body mass index(BMI), blood pressure, serum lipids, fasting plasma glucose(FPG), 2 hours plasma glucose(2hPG), HbAlc, fasting C-pepitide, fasting insulin, insulin resistance index(HOMA-IR), nesfatin-1 and LFC were measured at baseline and 8 weeks after treatment, and the side effects of the drug were also observed. LFC was measured by Magnetic resonance spectroscopy(1H-MRS). Results   Compared with the baseline levels,the levels of weight、HbA1c、2hPG and systoblic blood pressure significantly decreased after the treatment with exenatide(P＜0.01). FBG、 HOMA-IR and diastolic blood pressure obviously declined after the treatment (P＜0.05). The level of nesfatin-1 was obviously higher than that before the treatment(1.32±0.47 vs 0.92±0.62, P＜0.05). The level of LFC significantly decreased after the treatment［12.10(7.90%21.20%)% vs 7.60(5.30%15.60%)%, P＜0.01］.The decrease of HOMA-IR and BMI were independent impact factors for LFC as shown by multiple stepwise regression analysis. Conclusion   Exenatide can effectively control the blood glucose，improve the level of nesfatin-1 and reduce the liver fat contents, which is expected to become the new choice for obese type 2 diabetes mellitus.

Key words: Exenatide; Type 2 diabetes mellitus; Nesfatin-1; Liver fat contents; Magnetic resonance spectroscopy