JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2015, Vol. 53 ›› Issue (11): 64-68.doi: 10.6040/j.issn.1671-7554.0.2015.338

• Clinical Medicine • Previous Articles     Next Articles

Effect of lansoprazole and exenatide on gastrin and oxyntomodulin in patients with type 2 diabetes

LI Hanbing, GAO Yanyan, LI Li, CAO Caixia, XIAN Yuxin, WANG Jing, NIU Jiapeng   

  1. Department of Endocrinology, East Hospital, the Affiliated Hospital of Qingdao University, Qingdao 266100, Shandong, China
  • Received:2015-04-01 Online:2015-11-10 Published:2015-11-10

Abstract: Objective To observe glucose and lipids levels, body composition and insulin sensitivity before and after the treatment of exenatide and lansoprazole in type 2 diabetes mellitus (T2DM) patients, and to explore the effects of lansoprazole on the serum gastrin and oxyntomodulin (OXM). Methods Fifty-four obese patients with T2DM were randomly divided into combined treatment group (n=27) and exenatide group (n=27). Therapeutic plan of combined treatment group: 10 μg exenatide (subcutaneous injection one hour before breakfast and dinner) plus 15 mg lansoprazole were applied based on the original scheme; therapeutic plan of exenatide group: 10 μg exenatide (subcutaneous injection one hour before breakfast and dinner) was applied based on the original scheme. After 8 weeks of treatment, the changes in weight, body composition, blood pressure, fasting blood glucose (FBG), serum lipids, hepatic and renal functions, fasting insulin, glycosylated hemoglobin (HbA1c), insulin resistance index (HOMA-IR), serum gastrin and OXM were measured. Results Body weight, body composition, low densith lipoprotein (LDL), FBG, HbA1c, HOMA-IR and systolic pressure decreased significantly after treatment in both two groups (P<0.05). Comapred withexenatide group, gastrointestinal discomfort was alleviated, serum gastrin level increased [(160.76±8.93) vs (95.30±6.01) ng/L, P<0.05], FBG [(8.06±2.33) vs (8.51±2.71)mmol/L, P<0.05] and HbA1c[(7.79±0.78) vs (7.87±0.81)%, P<0.05] levels decresed in combined treatment group. The changes of ALT, AST, uric acid (UA), serum creatinine (Scr), blood urine nitrogen (BUN), high density lipoprotein (HDL) and OXM in two groups had no statistical differences (P>0.05). Correlation regression analysis showed that the decrease of HbA1c was associated with the increase of gastrin after treatment of exenatide and lansoprazole(r=-0.302, P<0.05). Conclusion Lansoprazole can alleviate gastrointestinal discomfort caused by exenatide in the early stage and reduce the blood glucose levels in obese T2DM patients, which may be related to the increase of gastrin. However, lansoprazole may have not any effects in the changes of oxyntomodulin.

Key words: Type 2 diabetes mellitus, Exenatide, Lansoprazole, Gastrin

CLC Number: 

  • R589
[1] Patel V, Joharapurkar A, Dhanesha N, et al. Combination of omeprazole with GLP-1 agonist therapy improves insulin sensitivity and antioxidant activity in liver in type 1 diabetic mice[J]. Pharmacol Rep, 2013, 65(4):927-936.
[2] U.K. Prospective Diabetes Study Group. U.K. prospective diabetes study 16. Overview of 6 years therapy of type Ⅱ diabetes a progressive disease. [J]. Diabetes, 1995, 44(11):1249-1258.
[3] Motoyuki T, Yoshio F, Toyoyoshi U, et al. Combination treatment of db/db mice with exendin-4 and gastrin preserves β-cell mass by stimulating β-cell growth and differentiation[J]. Diabetes Investig, 2010, 1(5):172-183.
[4] Suarez-Pinzon WL, Power RF, Yan Y, et al. Combination therapy with glucagon-like peptide-1 and gastrin restores normoglycemia in diabetic NOD mice[J]. Diabetes, 2008, 57(12):3281-3288.
[5] Spencer CM, Faulds D, Lansoprazloe. A reappraisal of its pharmacodynamic and pharmacokinetic properties, and its therapeutic efficacy in acid-related disorders[J]. Drugs, 1994, 48(3):404-430.
[6] Takebayashi K, Sakurai S, Suzuki T, et al. Effect of combination therapy with alogliptin and lansoprazole on glycemic cntrol in patients with type 2 diabetes[J]. Endocr J, 2014, 61(10):1031-1039.
[7] Singh PK, Hota D, Dutta P, et al. Pantoprazole improves glycemic control in type 2 diabetes: a randomized, double-blind, placebo-controlled trial [J]. J Clin Endocrinol Metab, 2012, 97(11):E2105-E2108.
[8] Bödvarsdóttir TB, Hove KD, Gotfredsen CF, et al. Treatment with a proton pump inhibitor improves glycaemic control in Psammomys obesus, a model of type 2 diabetes [J]. Diabetologia, 2010, 53(10):2220-2223.
[9] Mefford IN, Wade EU. Proton pump inhibitors as a treatment method for type II diabetes[J]. Medical Hypotheses, 2009, 73(1):29-32.
[10] Yaron S, Judith M, Miri SR, et al. Gastrin: a distinct fate of neurogenin3 positive progenitor cells in the embryonic pancreas [J]. PLoS One, 2013, 8(8): e70397. doi:10.1371/journal.pone.0070397.
[11] Wang M, Racine JJ, Song X, et al. Mixed chimerism and growth factors augment beta cell regeneration and reverse late-stage type 1 diabetes [J]. Sci Transl Med, 2012, 4(133):133-159.
[12] Rooman I, Bouwens L. Combined gastrin and epidermal growth factor treatment induces islet regeneration and restores normoglycemia in C57B16/J mice treated with alloxan[J]. Diabetologia, 2004, 47(2):259-265.
[13] 郭娅棣,高燕燕,李莉,等.兰索拉唑对2型糖尿病患者血糖及胃泌素的影响[J].山东大学学报:医学版, 2013, 51(7): 62-66. GUO Yadi, GAO Yanyan, LI li, et al. Effects of lansoprazole therapy on the plasma glucose and gastrin in the patients with type 2 diabetes mellitus[J]. Journal of Shandong University: Health Sciences, 2013, 51(7):62-66.
[14] Alessandro P. Action and therapeutic potential of oxyntomodulin[J]. Mol Metab, 2014, 3(3):241-251.
[15] Kosinski JR, Hubert J, Carrington PE, et al. The glucagon receptor is involved in mediating the body weight-lowering effects of oxyntomodulin[J]. Obesity, 2012, 20(8):1566-1571.
[16] Deacon CF. Potential of liraglutide in the treatment of patients with type 2 diabetes[J]. Vasc Health Risk Manag, 2009, 5(1):199-211.
[17] Macconell L, Brown C, Gurney K, et al. Safety and tolerability of exenatide twice daily in patients with type 2 diabetes:integrated analysis of 5594 patients from 19 placebo-controlled and comparator-controlled clinical trials[J]. Diabetes Metab Syndr Obes, 2012, 5:29-41.
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