Comparison of exenatide and acarbose on intra-abdominal fat content in patients with obesity and type-2 diabetes: A randomized controlled trial.
To investigate exenatide, a GLP-1 analogue, compared with acarbose, for intra-abdominal fat reduction in patients with obesity and type-2 diabetes.



This randomized controlled trial included 36 patients with obesity and type-2 diabetes, who were metformin-unresponsive, receiving metformin/exenatide (GLP-1 group) or metformin/acarbose (control group) for 3 months. Primary end-point: intra-abdominal fat content from baseline to 3 months; Secondary end-points: changes in fasting blood glucose, glycated haemoglobin (HbAlc), fasting insulin, blood lipids, weight, body mass index, and inflammatory cytokines from baseline to 3 months.



Intra-abdominal fat content decreased in the GLP-1 group from baseline to 3 months (17,947±5804; 13,717±3628mm2, P=0.001, respectively), but was not significantly reduced in the control group (P=0.197) and at 3 months post-treatment, it was significantly lower in the GLP-1 group than control group (P=0.043). Glucose control, measured by HbA1c (GLP-1: 9.72±1.38; 7.09±0.60%, P<0.001, 9.46±1.25; 7.42±0.84%, P<0.001, respectively) and insulin resistance index LN(HOMA-IR) (GLP-1: 1.58±0.40; 1.01±0.33, P<0.001, Control: 1.53±0.57; 1.10±0.33, P=0.003, respectively) significantly improved in both groups with no significant difference between them. TNF-α, IL-6, and leptin were lower and adiponectin levels higher in the GLP-1 group at 3 months compared with baseline (all P<0.05), but not significantly changed in the control group. TNF-α, IL-6 and leptin levels were similar between groups. Adiponectin level was higher in the GLP-1 group than the control group at 3 months (P=0.025).



Combined exenatide/metformin reduced intra-abdominal fat content, and enhanced insulin resistance and inflammatory status in patients with obesity and type-2 diabetes, representing a novel treatment regimen.
Department of Endocrinology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: shili1204@sina.com.
Li
L
Shi
Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China. Electronic address: daitoudainaozj@sina.com.
Jing
J
Zhu
Department of Endocrinology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: 13815039666@163.com.
Ping
P
Yang
Department of Radiology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: txq01040005@163.com.
Xiaoqiang
X
Tang
Department of Endocrinology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: wenlongyuwenlong@126.com.
Wenlong
W
Yu
Department of Radiology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: pcj424815@sina.com.
Changjie
C
Pan
Department of Endocrinology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: czshenmy@126.com.
Moyu
M
Shen
Department of Endocrinology, The Affiliated Drum Tower Hospital of Nanjing Medical University, No. 321 Zhongshan Road, Nanjing, Jiangsu 210008, China. Electronic address: zhudalong@nju.edu.cn.
Dalong
D
Zhu
Department of Endocrinology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: chengjinluo567@sina.com.
Jinluo
J
Cheng
Department of Endocrinology, Changzhou No. 2 Peoples' Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213003, China. Electronic address: 0818yezi@163.com.
Xinhua
X
Ye
D020909:Acarbose / Q000627:therapeutic use*; D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D023381:Endpoint Determination; D000077270:Exenatide; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood; D050152:Intra-Abdominal Fat / Q000187:drug effects*; D020738:Leptin / Q000097:blood; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy*; D010455:Peptides / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014688:Venoms / Q000627:therapeutic use*; D055105:Waist Circumference; D055815:Young Adult
D020909:Acarbose; D052242:Adiponectin; D001786:Blood Glucose; D000077270:Exenatide; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D015850:Interleukin-6; D020738:Leptin; D008687:Metformin; D010455:Peptides; D014409:Tumor Necrosis Factor-alpha; D014688:Venoms; C508600:IL6 protein, human
Exenatide; Inflammatory factors; Intra-abdominal fat; Type-2 diabetes