Morano Susanna, Romagnoli Elisabetta, Filardi Tiziana, Nieddu Luciano, Mandosi Elisabetta, Fallarino Mara, Turinese Irene, Dagostino Mariangela Pia, Lenzi Andrea, Carnevale Vincenzo
Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy,
Acta Diabetol. 2015 Aug;52(4):727-32. doi: 10.1007/s00592-014-0710-z. Epub 2015 Jan 11.
Glucagon-like peptide 1 receptor agonists (GLP-1 RA) induce weight loss and reduction in adipose tissue, but the effects of GLP-1 RA on the distribution of fat deposits have been poorly investigated.
In 25 patients with type 2 diabetes (16 females and 9 males, mean age 63.5 ± 8.8 years), treated with GLP-1 RA (exenatide, n. 12; liraglutide, n.13), both before and 3 months after starting treatment, an abdominal ultrasonographic scan, with Doppler of renal arteries, and echocardiography were performed. Subcutaneous fat width (peri-umbilical and sub-xiphoid), deep fat deposits (pre-aortic, peri-renal, and epicardial), and renal resistive index (RI) were evaluated.
GLP-1 RA induced highly significant (p < 0.001) decrease in BMI and in fat thickness at all the assessed sites, without differences between exenatide and liraglutide treatment. A slight decrease in RI (p = 0.055) was also found. The percent changes of fat thickness was different between sites (p < 0.025), and the changes in subcutaneous deposits showed no significant correlation (p = 0.064) with those of deep fat deposits.
A short course of treatment with GLP-1 RA, besides weight loss, induces a redistribution of adipose tissue deposits, possibly contributing to a better cardiovascular risk profile in patients with type 2 diabetes mellitus.
胰高血糖素样肽1受体激动剂（GLP-1 RA）可导致体重减轻和脂肪组织减少，但GLP-1 RA对脂肪沉积分布的影响尚未得到充分研究。
对25例2型糖尿病患者（16例女性和9例男性，平均年龄63.5±8.8岁），在开始使用GLP-1 RA（艾塞那肽，12例；利拉鲁肽，13例）治疗前及治疗3个月后，进行腹部超声扫描（包括肾动脉多普勒检查）和超声心动图检查。评估皮下脂肪宽度（脐周和剑突下）、深部脂肪沉积（腹主动脉前、肾周和心外膜）以及肾阻力指数（RI）。
GLP-1 RA使所有评估部位的BMI和脂肪厚度均显著降低（p<0.001），艾塞那肽和利拉鲁肽治疗之间无差异。还发现RI略有降低（p = 0.055）。各部位脂肪厚度的百分比变化不同（p<0.025），皮下脂肪沉积的变化与深部脂肪沉积的变化无显著相关性（p = 0.064）。
短期使用GLP-1 RA治疗，除了减轻体重外，还会引起脂肪组织沉积的重新分布，这可能有助于改善2型糖尿病患者的心血管风险状况。
