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Effects of combined exenatide and pioglitazone therapy on hepatic fat content in type 2 diabetes.
Obesity (Silver Spring). 2011 Dec; 19(12):2310-5.O

Abstract

We examined the effects of combined pioglitazone (peroxisome proliferator-activated receptor-γ (PPAR-γ) agonist) and exenatide (GLP-1 receptor agonist) therapy on hepatic fat content and plasma adiponectin levels in patients with type 2 diabetes (T2DM). Twenty-one T2DM patients (age = 52 ± 3 years, BMI = 32.0 ± 1.5, hemoglobin A(1c) (HbA(1c)) = 8.2 ± 0.4%) on diet and/or metformin received additional treatment with either pioglitazone 45 mg/day for 12 months (n = 10) or combined therapy with pioglitazone (45 mg/day) and exenatide (10 µg subcutaneously twice daily) for 12 months (n = 11). At baseline, hepatic fat content and plasma adiponectin levels were similar between the two treatment groups. Pioglitazone reduced fasting plasma glucose (FPG) (P < 0.05), fasting free fatty acid (FFA) (P < 0.05), and HbA(1c) (Δ = 1.0%, P < 0.01), while increasing plasma adiponectin concentration by 86% (P < 0.05). Hepatic fat (magnetic resonance spectroscopy (MRS)) was significantly reduced following pioglitazone treatment (11.0 ± 3.1 to 6.5 ± 1.9%, P < 0.05). Plasma triglyceride concentration decreased by 14% (P < 0.05) and body weight increased significantly (Δ = 3.7 kg). Combined pioglitazone and exenatide therapy was associated with a significantly greater increase in plasma adiponectin (Δ = 193%) and a significantly greater decrease in hepatic fat (12.1 ± 1.7 to 4.7 ± 1.3%) and plasma triglyceride (38%) vs. pioglitazone therapy despite the lack of a significant change in body weight (Δ = 0.2 kg). Hepatic injury biomarkers aspartate aminotransferase and alanine aminotransferase (ALT) were significantly decreased by both treatments; however, the reduction in ALT was significantly greater following combined pioglitazone and exenatide therapy. We conclude that combined in patients with T2DM, pioglitazone and exenatide therapy is associated with a greater reduction in hepatic fat content as compared to the addition of pioglitazone therapy (Δ = 61% vs. 41%, P < 0.05).

Authors+Show Affiliations

Diabetes and Endocrinology Division, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21660077

Citation

Sathyanarayana, Padma, et al. "Effects of Combined Exenatide and Pioglitazone Therapy On Hepatic Fat Content in Type 2 Diabetes." Obesity (Silver Spring, Md.), vol. 19, no. 12, 2011, pp. 2310-5.
Sathyanarayana P, Jogi M, Muthupillai R, et al. Effects of combined exenatide and pioglitazone therapy on hepatic fat content in type 2 diabetes. Obesity (Silver Spring). 2011;19(12):2310-5.
Sathyanarayana, P., Jogi, M., Muthupillai, R., Krishnamurthy, R., Samson, S. L., & Bajaj, M. (2011). Effects of combined exenatide and pioglitazone therapy on hepatic fat content in type 2 diabetes. Obesity (Silver Spring, Md.), 19(12), 2310-5. https://doi.org/10.1038/oby.2011.152
Sathyanarayana P, et al. Effects of Combined Exenatide and Pioglitazone Therapy On Hepatic Fat Content in Type 2 Diabetes. Obesity (Silver Spring). 2011;19(12):2310-5. PubMed PMID: 21660077.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of combined exenatide and pioglitazone therapy on hepatic fat content in type 2 diabetes. AU - Sathyanarayana,Padma, AU - Jogi,Medhavi, AU - Muthupillai,Raja, AU - Krishnamurthy,Ramkumar, AU - Samson,Susan L, AU - Bajaj,Mandeep, Y1 - 2011/06/09/ PY - 2011/6/11/entrez PY - 2011/6/11/pubmed PY - 2012/5/10/medline SP - 2310 EP - 5 JF - Obesity (Silver Spring, Md.) JO - Obesity (Silver Spring) VL - 19 IS - 12 N2 - We examined the effects of combined pioglitazone (peroxisome proliferator-activated receptor-γ (PPAR-γ) agonist) and exenatide (GLP-1 receptor agonist) therapy on hepatic fat content and plasma adiponectin levels in patients with type 2 diabetes (T2DM). Twenty-one T2DM patients (age = 52 ± 3 years, BMI = 32.0 ± 1.5, hemoglobin A(1c) (HbA(1c)) = 8.2 ± 0.4%) on diet and/or metformin received additional treatment with either pioglitazone 45 mg/day for 12 months (n = 10) or combined therapy with pioglitazone (45 mg/day) and exenatide (10 µg subcutaneously twice daily) for 12 months (n = 11). At baseline, hepatic fat content and plasma adiponectin levels were similar between the two treatment groups. Pioglitazone reduced fasting plasma glucose (FPG) (P < 0.05), fasting free fatty acid (FFA) (P < 0.05), and HbA(1c) (Δ = 1.0%, P < 0.01), while increasing plasma adiponectin concentration by 86% (P < 0.05). Hepatic fat (magnetic resonance spectroscopy (MRS)) was significantly reduced following pioglitazone treatment (11.0 ± 3.1 to 6.5 ± 1.9%, P < 0.05). Plasma triglyceride concentration decreased by 14% (P < 0.05) and body weight increased significantly (Δ = 3.7 kg). Combined pioglitazone and exenatide therapy was associated with a significantly greater increase in plasma adiponectin (Δ = 193%) and a significantly greater decrease in hepatic fat (12.1 ± 1.7 to 4.7 ± 1.3%) and plasma triglyceride (38%) vs. pioglitazone therapy despite the lack of a significant change in body weight (Δ = 0.2 kg). Hepatic injury biomarkers aspartate aminotransferase and alanine aminotransferase (ALT) were significantly decreased by both treatments; however, the reduction in ALT was significantly greater following combined pioglitazone and exenatide therapy. We conclude that combined in patients with T2DM, pioglitazone and exenatide therapy is associated with a greater reduction in hepatic fat content as compared to the addition of pioglitazone therapy (Δ = 61% vs. 41%, P < 0.05). SN - 1930-739X UR - https://www.unboundmedicine.com/medline/citation/21660077/Effects_of_combined_exenatide_and_pioglitazone_therapy_on_hepatic_fat_content_in_type_2_diabetes_ L2 - https://doi.org/10.1038/oby.2011.152 DB - PRIME DP - Unbound Medicine ER -