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Liu L, Wang R, Gao J, Yan J, Zhang J, Zhang Z, Liu J, Lin H, Rao S, Yao X, Wu W, Bian H, Wang X, Guo S, Gao X, Yan H. Insulin Glargine is More Suitable Than Exenatide in Preventing Muscle Loss in Non-Obese Type 2 Diabetic Patients with NAFLD. Exp Clin Endocrinol Diabetes 2023; 131:583-588. [PMID: 37524110 PMCID: PMC10645484 DOI: 10.1055/a-2145-1004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 06/28/2023] [Indexed: 08/02/2023]
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.
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Affiliation(s)
- Lin Liu
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
- Fudan Institute for Metabolic Disease, Fudan University, Shanghai,
China
| | - Ruwen Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai,
China
| | - Jian Gao
- Department of Nutrition, Zhongshan Hospital, Fudan
University
- Center of Clinical Epidemiology and Evidence-based Medicine, Fudan
University
| | - Jianhua Yan
- Shanghai Key Laboratory of Molecular Imaging, Shanghai University of
Medicine and Health Sciences, Shanghai, China
| | - Jingtian Zhang
- Department of Nutrition, Zhongshan Hospital, Fudan
University
| | - Zhitian Zhang
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
| | - Jiaojiao Liu
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
| | - Huandong Lin
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
- Fudan Institute for Metabolic Disease, Fudan University, Shanghai,
China
| | - Shengxiang Rao
- Department of Radiology, Zhongshan Hospital, Fudan University,
Shanghai, China
| | - Xiuzhong Yao
- Department of Radiology, Zhongshan Hospital, Fudan University,
Shanghai, China
| | - Weiyun Wu
- Department of Laboratory Medicine, Zhongshan Hospital, Fudan
University, Shanghai, China
| | - Hua Bian
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
- Fudan Institute for Metabolic Disease, Fudan University, Shanghai,
China
| | - Xiangyu Wang
- Department of Nutrition, Zhongshan Hospital, Fudan
University
| | - Shanshan Guo
- School of Kinesiology, Shanghai University of Sport, Shanghai,
China
- School of Life Sciences, Fudan University, Shanghai,
China
| | - Xin Gao
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
- Fudan Institute for Metabolic Disease, Fudan University, Shanghai,
China
| | - Hongmei Yan
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
- Fudan Institute for Metabolic Disease, Fudan University, Shanghai,
China
- Department of Endocrinology and Metabolism, Wusong Branch of Zhongshan
Hospital, Fudan University, Shanghai, China.
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