title: Evaluation of exenatide versus insulin glargine for the impact on endothelial functions and cardiovascular risk markers.
abstract: OBJECTIVE
  To demonstrate the efficacy of exenatide versus insulin glargine on endothelial functions and cardiovascular risk markers.
  
  
  METHODS
  Thirty-four insulin and incretin-naive patients with type 2 diabetes mellitus (body mass index 25-45 kg/m(2)) who received metformin for at least two months were randomized to exenatide or insulin glargine treatment arms and followed-up for 26 weeks. Measurements of endothelial functions were done by ultrasonography, cardiovascular risk markers by serum enzyme-linked immunosorbent assay, and total body fat mass by bioimpedance.
  
  
  RESULTS
  Levels of high sensitivity-C-reactive protein and endothelin-1 decreased (27.5% and 18.75%, respectively) in the exenatide arm. However, in the insulin glargine arm, fibrinogen, monocyte chemoattractant protein-1, leptin and endothelin-1 levels (13.4, 30.2, 47.5, and 80%, respectively) increased. Post-treatment flow mediated dilatation and endothelium independent vascular responses were significantly higher in both arms (p=0.0001, p=0.0001). Positive correlation was observed between the changes in body weight and endothelium-independent vasodilatation, leptin, plasminogen activator inhibitor type 1 and endothelin-1 in both arms (r=0.376, r=0.507, r=0.490, r=0.362, respectively).
  
  
  CONCLUSIONS
  Insulin glargine improved endothelial functions, without leading to positive changes in cardiovascular risk markers. Exenatide treatment of 26 weeks resulted in reduced body weight and improvement in certain cardiovascular risk markers and endothelial functions.
authors.affiliation: Department of Endocrinology and Metabolism, Kocaeli University Faculty of Medicine, Kocaeli, Turkey. Electronic address: erengurkan@ttmail.com.
authors.forename: Eren
authors.initials: E
authors.lastname: Gurkan
authors.affiliation: Department of Endocrinology and Metabolism, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Ilhan
authors.initials: I
authors.lastname: Tarkun
authors.affiliation: Department of Cardiology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Tayfun
authors.initials: T
authors.lastname: Sahin
authors.affiliation: Department of Endocrinology and Metabolism, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Berrin
authors.initials: B
authors.lastname: Cetinarslan
authors.affiliation: Department of Endocrinology and Metabolism, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Canturk
mesh_terms: D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000097:blood / Q000503:physiopathology* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D019332:Endothelin-1 / Q000097:blood; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*; D004797:Enzyme-Linked Immunosorbent Assay; D000077270:Exenatide; D005260:Female; D005500:Follow-Up Studies; D052216:Glucagon-Like Peptide 1; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000627:therapeutic use*; D011379:Prognosis; D012307:Risk Factors; D014463:Ultrasonography; D014664:Vasodilation / Q000187:drug effects*; D014688:Venoms / Q000627:therapeutic use*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D019332:Endothelin-1; D000077270:Exenatide; D052216:Glucagon-Like Peptide 1; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; D010455:Peptides; D014688:Venoms
keywords: Cardiovascular disease; Exenatide; Insulin analogues; Type 2 diabetes