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

Description

This study was undertaken to determine whether exenatide has a direct effect on postprandial lipid and lipoprotein levels without the effect on body weight or fasting glucose by testing the acute effect of a single injection. This 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). Analyses revealed that a single dose of exenatide improved considerably several postprandial cardiovascular risk factors. In fact, exenatide abolished postprandial increases in triglyceride concentrations, inhibited postprandial increases of remnant lipoprotein cholesterol and triglycerides, suppressed rises in apolipoprotein CIII, and induced prolonged reductions in free fatty acid concentrations. These results showed a robust effect of exenatide to inhibit postprandial hyperlipidmia even after consumption of a high-fat meal. Due to the acute context of this study, these results suggest that exenatide may directly reduce postprandial lipids independently of its effects on glucose control or of chronic changes in body weight or insulin resistance. In their comment, Bandsma RHJ and Lewis GF underlined the importance of determining the mechanism for the effect of glucagon-like peptide on postprandial lipid metabolism in further studies due to the potential additional clinical benefits of GLP-1 receptor agonists in patients with type 2 diabetes observed in this study.