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人胰高血糖素样肽-1类似物利拉鲁肽对2型糖尿病患者体重、体脂面积及体脂相关标志物的影响。

Effects of liraglutide, a human glucagon-like peptide-1 analogue, on body weight, body fat area and body fat-related markers in patients with type 2 diabetes mellitus.

作者信息

Suzuki Daisuke, Toyoda Masao, Kimura Moritugu, Miyauchi Masaaki, Yamamoto Naoyuki, Sato Hiroki, Tanaka Eitaro, Kuriyama Yusuke, Miyatake Han, Abe Makiko, Umezono Tomoya, Fukagawa Masafumi

机构信息

Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Japan.

出版信息

Intern Med. 2013;52(10):1029-34. doi: 10.2169/internalmedicine.52.8961. Epub 2013 May 15.

Abstract

OBJECTIVE

To evaluate the effects of six-month liraglutide treatment on body weight, visceral and subcutaneous fat and related markers in Japanese type 2 diabetic patients.

METHODS

A total of 59 patients with type 2 diabetes were treated with liraglutide (0.3 mg/day for ≥1 week and then 0.6 mg/day for ≥1 week, gradually increasing the dose to 0.9 mg/day) for six months. Changes in body weight, body mass index (BMI), HbA1c, the fasting blood glucose level, visceral and subcutaneous fat areas, hepatic and renal CT values and the associated markers proinsulin, adiponectin and pentraxin (PTX) 3 were measured.

RESULTS

The study included one treatment-naïve patient, 10 patients who were switched from oral antidiabetic drugs and 35 patients who were switched from insulin therapy. At six months after treatment, the preprandial blood glucose levels were higher (148.8±40.5 mg/dL) than the baseline values (130.8±36.7, p<0.05); however, body weight, BMI and abdominal circumference were lower, and the liver/kidney CT ratio improved significantly from 1.64±0.44 at baseline to 1.78±0.42. An analysis of the patients who were not pretreated with insulin resistance ameliorators showed that six months of liraglutide treatment significantly decreased the subcutaneous but not visceral fat areas, significantly decreased the serum adiponectin levels and significantly increased the serum PTX3 levels.

CONCLUSION

In addition to its glucose-lowering effects, liraglutide exhibits weight loss promotion actions, reducing subcutaneous fat areas in particular. The weight and total fat area reduction properties of liraglutide are likely to be beneficial when this medication is used in combination with other oral antidiabetic drugs and insulin.

摘要

目的

评估利拉鲁肽治疗6个月对日本2型糖尿病患者体重、内脏及皮下脂肪和相关标志物的影响。

方法

共59例2型糖尿病患者接受利拉鲁肽治疗(起始剂量0.3mg/天,持续≥1周,然后0.6mg/天,持续≥1周,逐渐增加剂量至0.9mg/天),疗程6个月。测量体重、体重指数(BMI)、糖化血红蛋白(HbA1c)、空腹血糖水平、内脏及皮下脂肪面积、肝脏和肾脏CT值以及相关标志物胰岛素原、脂联素和五聚素(PTX)3的变化。

结果

该研究纳入1例未接受过治疗的患者、10例从口服降糖药转换而来的患者以及35例从胰岛素治疗转换而来的患者。治疗6个月后,餐前血糖水平高于基线值(148.8±40.5mg/dL,基线值为130.8±36.7,p<0.05);然而,体重、BMI和腹围降低,肝脏/肾脏CT比值从基线时的1.64±0.44显著改善至1.78±0.42。对未预先使用胰岛素抵抗改善剂的患者分析显示,利拉鲁肽治疗6个月可显著降低皮下脂肪面积,但对内脏脂肪面积无显著影响,显著降低血清脂联素水平,并显著升高血清PTX3水平。

结论

除降糖作用外,利拉鲁肽还具有促进体重减轻的作用,尤其可减少皮下脂肪面积。当利拉鲁肽与其他口服降糖药及胰岛素联合使用时,其减轻体重和减少总脂肪面积的特性可能有益。

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