Alterations in energy balance following exenatide administration

Author:

Bradley David P.1,Kulstad Roger2,Racine Natalie3,Shenker Yoram4,Meredith Melissa4,Schoeller Dale A.3

Affiliation:

1. Department of Geriatrics and Nutritional Sciences, Washington University,4488 Forest Park, St. Louis, MO 63102, USA.

2. Department of Endocrinology, Marshfield Clinic-Weston Center, Weston, WI 54476, USA.

3. Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA.

4. Division of Endocrinology, University of Wisconsin-Madison, Madison, WI, USA.

Abstract

Exenatide is a medication similar in structure and effect to native glucagon-like peptide-1, an incretin hormone with glucose-lowering properties. The aim of the study was to measure the change in total energy expenditure (TEE) and body composition during exenatide administration and by deduction the relative contributions of energy expenditure and energy intake to exenatide-induced weight loss. Forty-five obese (body mass index, 30–40 kg·m–2) subjects were identified. After exclusion criteria application, 28 subjects entered into the study and 18 subjects (12 female, 6 male) completed the study, which consisted of 6 visits over 14 weeks and injection of exenatide for an average of 84 ± 5 days. Respiratory gas analysis and doubly labeled water measurements were performed before initiation of exenatide and after approximately 3 months of exenatide administration. The average weight loss from the beginning of injection period to the end of the study in completed subjects was 2.0 ± 2.8 kg (p = 0.01). Fat mass declined by 1.3 ± 1.8 kg (p = 0.01) while the fat-free mass trended downward but was not significant (0.8 ± 2.2 kg, p = 0.14). There was no change in weight-adjusted TEE (p = 0.20), resting metabolic rate (p = 0.51), or physical activity energy expenditure (p = 0.38) and no change in the unadjusted thermic effect of a meal (p = 0.37). The significant weight loss because of exenatide administration was thus the result of decreasing energy intake. In obese nondiabetic subjects, exenatide administration did not increase TEE and by deduction the significant weight loss and loss of fat mass was due to decreased energy intake.

Publisher

Canadian Science Publishing

Subject

Physiology (medical),Nutrition and Dietetics,Physiology,General Medicine,Endocrinology, Diabetes and Metabolism

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