Endocrine Abstracts

Aim: Ghrelin plays an important role in the stimulation of food intake and long-term regulation of body weight. In present study we investigate the long term effect of exenatide treatment on serum fasting ghrelin levels in patients with type 2 diabetes mellitus.

Methods: Type 2 diabetic patients who were using metformin with and without the other oral antihiperglycemic drugs on a stable dose for at least 3 months were enrolled in the study. Body mass index (BMI) > 35 kg/m² and hemoglobin A1c (HbA1c) > 7.0% were the additional inclusion criteria. Oral antihyperglycemic drugs other than metformin were stopped and metformin treatment was continued at 2000 mg per day. Exenatide treatment was initiated at 5 mcg per dose sc twice daily and after one month the dose of exenatide was increased to 10 mcg twice daily. Changes in anthropometric variables, glycemic control, lipid parameters, and total ghrelin levels were evaluated at baseline and following 12 weeks of treatment.

Results: Thirty-eight patients (male/female=7/31) with type 2 diabetes mellitus entered to the study. Mean age of patients was 50.5±8.8 years with mean diabetes duration of 8.5±4.9 years. Mean BMI was 41.6±6.3 kg/m² and mean HbA1c of patients was 8.9±1.4%. Percentage change in weight of patients was −5.2±3.7% following 12 weeks of treatment. BMI and HbA1c levels of patients were decreased significantly (P<0.001 and P<0.001; respectively) while there was no change in lipid parameters. Serum fasting ghrelin levels were suppressed significantly after 12 weeks of exenatide treatment compared with baseline values (328.4±166.8 vs 245.3±164.8 pg/ml) (P=0.024).

Conclusion: These results suggest that the effect of exenatide on weight loss may be related with the suppression of serum fasting ghrelin levels, which is an orexigenic peptide.