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.