Background: Previous studies found that adipocytokines could be altered by exenatide in patients with newly diagnosed T2DM. Whether the changes of the metabolic indices induced by exenatide have impacts on adipocytokines is still unclear. Thus, this study aimed to investigate the factors influencing the changes of leptin and adiponectin, two important adipocytokines in the pathogenesis of T2DM, in patients with newly diagnosed T2DM treated with exenatide.
Methods: In this multicenter prospective study, drug-naive patients with newly diagnosed T2DM were treated with exenatide for 48 weeks. The anthropometric data, HbA1c, β-cell function, insulin resistance, leptin, and adiponectin were assessed at baseline and at the end of the study.
Results: One hundred and ten patients completed the study. HbA1c, HOMA-IR and acute insulin response were improved significantly (P<0.001). Body weight and body mass index (BMI) were significantly reduced (P<0.001). Adiponectin significantly increased [5613(3353∼8352) to 7774 (4350∼12207) ng/ml, median(interquartile), P<0.001], while leptin non-significantly increased [3308(1528∼5138) to 3395(1480∼5076) pg/ml, P=0.401]. The change of leptin [∆leptin: 160 (-486∼1226) pg/ml] was significantly correlated with the change of BMI and weight [∆BMI: -1.1(-2.0∼-0.4) kg/m2, r= 0.4, P=0.02; ∆weight: -3.0 (-5.7∼-1.0) kg, r=0.3, P=0.03, respectively]. ∆adiponectin was correlated with the change of HOMA-B (r= -0.4, P=0.04), but not with ∆BMI or ∆weight. Multiple linear regression using the anthropometric data or laboratory indices as independent variables and ∆leptin and ∆adiponectin as dependent variables showed that ∆leptin was independently associated with ∆weight (B= 380.8, 95% CI: 34.3∼ 727.3, P=0.032) after adjusting for the change of HbA1c, while ∆adiponectin was not.
Conclusions: The change of leptin might be influenced by the weight loss but not the hypoglycemic effect induced by exenatide in newly diagnosed T2DM.
H.R. Deng: None. W. Xu: None. X. Yang: None. L. Zeng: None. B. Yao: None. J. Weng: None.
National Natural Science Foundation of China (81770821 to W.X.)