Insulin Glargine is More Suitable Than Exenatide in Preventing Muscle Loss in Non-Obese Type 2 Diabetic Patients with NAFLD.

AIM: This study investigated the effects of insulin glargine and exenatide on the muscle mass of patients with newly diagnosed type 2 diabetes (T2DM) and nonalcoholic fatty liver disease (NAFLD). METHODS: We performed a post-hoc analysis of our previously study, a 24-week randomized controlled multicenter clinical trial (ClinicalTrials.gov, NCT02303730). Seventy-six patients were randomly assigned 1:1 to receive insulin glargine or exenatide treatment. The changes in psoas muscle area (PMA) (mm) were obtained with the cross-sectional Dixonfat magnetic resonance images at the fourth lumber vertebra. RESULTS: There were no significant differences in age, BMI, gender, and PMA in insulin glargine and exenatide groups at baseline. After treatment, PMA tended to increase by 13.13 (-215.52, 280.80) mm in the insulin glargine group and decrease by 149.09 (322.90-56.39) mm in the exenatide group (both 0.05). Subgroup analysis showed a 560.64 (77.88, 1043.40) (mm) increase of PMA in the insulin group relative to the Exenatide group in patients with BMI<28 kg/m (0.031) after adjusting for gender, age, and research center. Interaction analysis showed an interaction between BMI and treatment (0.009). However, no interaction was observed among subgroups with a BMI≥28 kg/m or with different genders and ages. CONCLUSION: Compared to exenatide, insulin glargine can relativity increase PMA in patients with T2DM having BMI<28 kg/m and NAFLD.