Exenatide as a Treatment for Diabetes and Obesity: Implications for Cardiovascular Risk Reduction
Exenatide as a Treatment for Diabetes and Obesity: Implications for Cardiovascular Risk Reduction
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DOI：
10.1007/s11883-008-0009-z
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发表时间：
2008-02-01
影响因子：
5.8
通讯作者：
Henry, Robert R.
中科院分区：
文献类型：
--
作者：
Mafong, Derek D.;Henry, Robert R.
改善糖尿病患者预后的挑战之一是有效实施现有药物治疗。然而，目前的糖尿病治疗通常受到副作用如水肿、低血糖和体重增加的限制。了解肠促胰岛素在糖尿病病理生理学中的作用，导致了新治疗药物的开发。艾塞那肽是一类称为“肠促胰岛素模拟物”的新型药物中的第一种，其复制了内源性肠促胰岛素激素胰高血糖素样肽-1的几种葡萄糖调节作用。在临床试验中，2型糖尿病患者用艾塞那肽治疗显示血糖控制持续改善，空腹和餐后血糖水平降低，糖化血红蛋白水平改善。艾塞那肽对血糖控制的改善与体重的减轻相结合。血脂参数、血压和C-反应蛋白已被证明在艾塞那肽治疗的患者中得到有利的改善。艾塞那肽治疗的持续血糖改善和体重逐渐减轻支持向更有利的心血管风险特征转变，并可能对降低相关长期并发症的风险产生积极影响。
Among the challenges in improving outcomes in patients with diabetes is effectively implementing existing pharmacotherapies. However, current therapies for diabetes are often limited by adverse effects such as edema, hypoglycemia, and weight gain. Understanding the role of the incretin effect on the pathophysiology of diabetes has led to the development of new therapeutic agents. Exenatide is the first in a new class of agents termed "incretin mimetics," which replicate several glucoregulatory effects of the endogenous incretin hormone, glucagon-like peptide-1. In clinical trials, patients with type 2 diabetes treated with exenatide demonstrate sustained improvements in glycemic control, with reductions in fasting and postprandial glucose levels and improvements in glycosylated hemoglobin levels. Improvements in glycemic control with exenatide are coupled with reductions in body weight. Lipid parameters, blood pressure, and C-reactive protein have been shown to improve favorably in patients treated with exenatide. The sustained glycemic improvements and progressive reduction in body weight with exenatide treatment support a shift toward a more favorable cardiovascular risk profile and may have a positive impact on decreasing the risk of associated long-term complications.