Benefits of exenatide on obesity and non-alcoholic fatty liver disease with elevated liver enzymes in patients with type 2 diabetes.
BACKGROUND
The purpose of this study was to evaluate the advantages of exenatide treatment on obesity and non-alcoholic fatty liver disease (NAFLD) with elevated liver enzymes in patients with type 2 diabetes (T2D).


METHODS
A total of 60 newly diagnosed patients with obesity, NAFLD with elevated liver enzymes and T2D were included in the study. The patients were randomly divided into two groups. The exenatide treatment group (n = 30) were treated with exenatide and insulin glargine, and the intensive insulin therapy group (n = 30) were treated with insulin aspart and insulin glargine for 12 weeks. Selected clinical characteristics were determined, and ultrasonography was performed at both baseline and 12 weeks following treatment.


RESULTS
At baseline, the clinical characteristics were matched between the two groups. After 12 weeks, fasting blood glucose (FBG), postprandial blood glucose (PBG), glycosylated haemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG) and total bilirubin levels were significantly decreased in the two groups (p < 0.001). Body weight and waist circumference were significantly decreased in the exenatide group but increased in the intensive insulin group (p < 0.001). The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyl transpeptidase (γGGT) in the exenatide group were significantly lower than in the intensive insulin group (p < 0.001). The mean body weight change correlated with the levels of ALT, AST and γGGT change (ALT, r = 0.761; AST, r = 0.733; γGGT, r = 0.752; p < 0.001). Moreover, the reversal rate of fatty liver was significantly higher in the exenatide group (93.3%) than the intensive insulin group (66.7%) (p < 0.01).


CONCLUSIONS
Exenatide has a better hepatic-protective effect than intensive insulin therapy and perhaps represents a unique option for adjunctive therapy for patients with obesity, non-alcoholic fatty liver disease with elevated liver enzymes and T2D.
['Shao|Ning|N|', 'Kuang|Hong Yu|HY|', 'Hao|Ming|M|', 'Gao|Xin Yuan|XY|', 'Lin|Wen Jian|WJ|', 'Zou|Wei|W|']
D000328:Adult D015415:Biomarkers D015992:Body Mass Index D003131:Combined Modality Therapy D003924:Diabetes Mellitus, Type 2 D003927:Diet, Diabetic D004359:Drug Therapy, Combination D000077270:Exenatide D015444:Exercise D005260:Female D006442:Glycated Hemoglobin A D048550:Hepatic Insufficiency D006801:Humans D006943:Hyperglycemia D007004:Hypoglycemic Agents D000069036:Insulin Glargine D049528:Insulin, Long-Acting D008099:Liver D008297:Male D008875:Middle Aged D065626:Non-alcoholic Fatty Liver Disease D009765:Obesity D010455:Peptides D014463:Ultrasonography D014688:Venoms D055105:Waist Circumference D015431:Weight Loss
obesity non-alcoholic fatty liver disease (NAFLD) type 2 diabetes (T2D) exenatide (Exe)