Exenatide suppresses postprandial elevations in lipids and lipoproteins in individuals with impaired glucose tolerance and recent onset type 2 diabetes mellitus

Eric A. Schwartz, Juraj Koska, Michael P. Mullin, Iyad Syoufi, Dawn C. Schwenke, Peter D. Reaven

Research output: Contribution to journalArticle

123 Citations (Scopus)

Abstract

Objective: Chronic exenatide treatment in type 2 diabetes is associated with improved glucose control and fasting lipid levels, as well as weight loss. Less established is whether exenatide directly reduces postprandial lipid and lipoprotein levels without the reduction in body weight or fasting glucose and triglycerides levels that frequently occur with prolonged therapy. Therefore, the effect of a single injection of exenatide on postprandial lipids, remnant lipoproteins, and apolipoproteins was studied. Methods: A double-blinded, randomized, placebo-controlled, crossover study was conducted in 35 subjects (31 men and 4 women) with impaired glucose tolerance (n= 20) or recent onset type 2 diabetes (n= 15). A single subcutaneous injection of exenatide (10 μg) or normal saline was administered just prior to a high-calorie, fat-enriched breakfast meal. Concentrations of triglycerides (TG), apolipoproteins B-48 and CIII, non-esterified fatty acids (NEFA), and remnant lipoprotein (RLP) cholesterol and TG in serum or plasma were measured prior to the injection and for up to 8. h postprandially. Results: Exenatide markedly reduced postprandial elevation of TG, apolipoproteins B-48 and CIII, RLP-cholesterol and RLP-triglyceride (all p< 0.001). Postprandial declines in NEFA were less pronounced but persisted longer with exenatide compared to placebo (p< 0.05). These effects of exenatide were not affected either by glucose tolerance status or by treatment with statins. Conclusion: These results demonstrate that exenatide acutely and profoundly inhibits postprandial excursions of proatherogenic lipids and lipoproteins and may offer additional cardiovascular risk reduction (NCT00974272).

Original languageEnglish (US)
Pages (from-to)217-222
Number of pages6
JournalAtherosclerosis
Volume212
Issue number1
DOIs
StatePublished - Sep 1 2010
Externally publishedYes

Fingerprint

Glucose Intolerance
Type 2 Diabetes Mellitus
Lipoproteins
Lipids
Apolipoprotein B-48
Apolipoprotein C-III
Triglycerides
Glucose
Fasting
Fatty Acids
Placebos
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Injections
Breakfast
exenatide
Apolipoproteins
Subcutaneous Injections
Risk Reduction Behavior
Cross-Over Studies
Meals

Keywords

  • Apolipoprotein B-48
  • Apolipoprotein C-III
  • Exenatide
  • High-fat meal
  • NEFA
  • Remnant lipoproteins
  • Triglycerides

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Exenatide suppresses postprandial elevations in lipids and lipoproteins in individuals with impaired glucose tolerance and recent onset type 2 diabetes mellitus. / Schwartz, Eric A.; Koska, Juraj; Mullin, Michael P.; Syoufi, Iyad; Schwenke, Dawn C.; Reaven, Peter D.

In: Atherosclerosis, Vol. 212, No. 1, 01.09.2010, p. 217-222.

Research output: Contribution to journalArticle

Schwartz, Eric A. ; Koska, Juraj ; Mullin, Michael P. ; Syoufi, Iyad ; Schwenke, Dawn C. ; Reaven, Peter D. / Exenatide suppresses postprandial elevations in lipids and lipoproteins in individuals with impaired glucose tolerance and recent onset type 2 diabetes mellitus. In: Atherosclerosis. 2010 ; Vol. 212, No. 1. pp. 217-222.
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T1 - Exenatide suppresses postprandial elevations in lipids and lipoproteins in individuals with impaired glucose tolerance and recent onset type 2 diabetes mellitus

AU - Schwartz, Eric A.

AU - Koska, Juraj

AU - Mullin, Michael P.

AU - Syoufi, Iyad

AU - Schwenke, Dawn C.

AU - Reaven, Peter D.

PY - 2010/9/1

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AB - Objective: Chronic exenatide treatment in type 2 diabetes is associated with improved glucose control and fasting lipid levels, as well as weight loss. Less established is whether exenatide directly reduces postprandial lipid and lipoprotein levels without the reduction in body weight or fasting glucose and triglycerides levels that frequently occur with prolonged therapy. Therefore, the effect of a single injection of exenatide on postprandial lipids, remnant lipoproteins, and apolipoproteins was studied. Methods: A double-blinded, randomized, placebo-controlled, crossover study was conducted in 35 subjects (31 men and 4 women) with impaired glucose tolerance (n= 20) or recent onset type 2 diabetes (n= 15). A single subcutaneous injection of exenatide (10 μg) or normal saline was administered just prior to a high-calorie, fat-enriched breakfast meal. Concentrations of triglycerides (TG), apolipoproteins B-48 and CIII, non-esterified fatty acids (NEFA), and remnant lipoprotein (RLP) cholesterol and TG in serum or plasma were measured prior to the injection and for up to 8. h postprandially. Results: Exenatide markedly reduced postprandial elevation of TG, apolipoproteins B-48 and CIII, RLP-cholesterol and RLP-triglyceride (all p< 0.001). Postprandial declines in NEFA were less pronounced but persisted longer with exenatide compared to placebo (p< 0.05). These effects of exenatide were not affected either by glucose tolerance status or by treatment with statins. Conclusion: These results demonstrate that exenatide acutely and profoundly inhibits postprandial excursions of proatherogenic lipids and lipoproteins and may offer additional cardiovascular risk reduction (NCT00974272).

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KW - Triglycerides

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