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CC BY-NC-ND 4.0 · Exp Clin Endocrinol Diabetes 2023; 131(11): 583-588
DOI: 10.1055/a-2145-1004
Article

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

Lin Liu‡   *
1   Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
2   Fudan Institute for Metabolic Disease, Fudan University, Shanghai, China
,
Ruwen Wang‡   *
3   School of Kinesiology, Shanghai University of Sport, Shanghai, China
,
Jian Gao‡   *
4   Department of Nutrition, Zhongshan Hospital, Fudan University
5   Center of Clinical Epidemiology and Evidence-based Medicine, Fudan University
,
Jianhua Yan
6   Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China
,
Jingtian Zhang
4   Department of Nutrition, Zhongshan Hospital, Fudan University
,
Zhitian Zhang
1   Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
,
Jiaojiao Liu
1   Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
,
Huandong Lin
1   Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
2   Fudan Institute for Metabolic Disease, Fudan University, Shanghai, China
,
Shengxiang Rao
7   Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
,
Xiuzhong Yao
7   Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
,
Weiyun Wu
8   Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
,
Hua Bian
1   Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
2   Fudan Institute for Metabolic Disease, Fudan University, Shanghai, China
,
Xiangyu Wang
4   Department of Nutrition, Zhongshan Hospital, Fudan University
,
Shanshan Guo
3   School of Kinesiology, Shanghai University of Sport, Shanghai, China
9   School of Life Sciences, Fudan University, Shanghai, China
,
Xin Gao
1   Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
2   Fudan Institute for Metabolic Disease, Fudan University, Shanghai, China
,
Hongmei Yan
1   Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
2   Fudan Institute for Metabolic Disease, Fudan University, Shanghai, China
10   Department of Endocrinology and Metabolism, Wusong Branch of Zhongshan Hospital, Fudan University, Shanghai, China.
› Author Affiliations Funding Information Medical Guidance Project of Shanghai Science and Technology Commission — 19401931100 to Wang XY; Science and Technology Commission of Shanghai Municipality — http://dx.doi. org/10.13039/501100003399; 21ZR1413200 to HM Yan; Scientific Research and Development Foundation of Zhongshan Hospital, Fudan University — 2019ZSFZ10 to HD LIN
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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.

Key words

body composition - basal insulin - exenatide - fatty liver disease - type 2 diabetes - clinical trial

* These authors contributed equally: Lin Liu, Ruwen Wang, Jian Gao




Publication History

Received: 08 December 2022
Received: 27 June 2023

Accepted: 28 June 2023

Accepted Manuscript online:
31 July 2023

Article published online:
04 October 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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