de Luis Daniel Antonio, Diaz Soto Gonzalo, Izaola Olatz, Romero Enrique
Center of Investigation of endocrinology and Nutrition, Medicine School, Department of Endocrinology and Nutrition Hospital Clinico Universitario, University of Valladolid, Valladolid Spain.
Center of Investigation of endocrinology and Nutrition, Medicine School, Department of Endocrinology and Nutrition Hospital Clinico Universitario, University of Valladolid, Valladolid Spain.
J Diabetes Complications. 2015 May-Jun;29(4):595-8. doi: 10.1016/j.jdiacomp.2015.02.010. Epub 2015 Feb 25.
A polymorphism of GLP-1 R (rs6923761) has potential implications in weight loss and metabolic control. We decide to investigate the role of this polymorphism on metabolic changes and weight loss secondary to treatment with liraglutide.
A population of 90 patients with diabetes mellitus type 2 and overweight, unable to achieve glycemic control (HbA1c>7%) with metformin alone that require initiation of liraglutide treatment in progressive dose to 1.8mg/day subcutaneously, was analyzed.
Fifty one patients (56.7%) had the genotype GG and 39 (43.3%) patients; GA (30 patients, 33.3%) or AA (9 patients, 10%) (A allele carriers). In patients with both genotypes, body mass index (BMI), weight and fat decreased. The proportion of the mentioned reductions was higher in the variant allele carriers; BMI (-0.59±2.5kg/m(2) vs. -1.69±3.9kg/m(2); P<0.05), weight (-2.78±2.8kg vs. -4.52±4.6kg; P<0.05) and fat mass (-0.59±2.5kg vs. -1.69±3.9kg; P<0.05). Weight reduction after liraglutide treatment was greater in the A-allele carriers by 2.9kg (95% CI: 0.27-5.64). The decrease of basal glucose, HOMA-R and HbA1c was similar in both genotypes.
Our data showed better anthropometric parameters in overweight diabetic subjects with the variant allele (A) of rs6923761 GLP-1 R polymorphism. A allele carriers had a greater decrease in weight and fat mass after treatment with liraglutide. The present study is a preliminary observation, and its results need to be replicated with a higher number of patients in different populations.
胰高血糖素样肽-1受体(GLP-1 R)的一种多态性(rs6923761)在体重减轻和代谢控制方面具有潜在影响。我们决定研究这种多态性对利拉鲁肽治疗继发的代谢变化和体重减轻的作用。
分析了90例2型糖尿病超重患者,这些患者仅使用二甲双胍无法实现血糖控制(糖化血红蛋白>7%),需要开始皮下注射利拉鲁肽并逐渐增加剂量至1.8mg/天。
51例患者(56.7%)具有GG基因型,39例患者(43.3%)为GA(30例患者,33.3%)或AA(9例患者,10%)(A等位基因携带者)。在两种基因型的患者中,体重指数(BMI)、体重和脂肪均下降。上述降低比例在变异等位基因携带者中更高;BMI(-0.59±2.5kg/m²对-1.69±3.9kg/m²;P<0.05)、体重(-2.78±2.8kg对-4.52±4.6kg;P<0.05)和脂肪量(-0.59±2.5kg对-1.69±3.9kg;P<0.05)。利拉鲁肽治疗后,A等位基因携带者的体重减轻幅度更大,为2.9kg(95%可信区间:0.27-5.64)。两种基因型的基础血糖、胰岛素抵抗指数(HOMA-R)和糖化血红蛋白的降低情况相似。
我们的数据显示,rs6923761 GLP-1 R多态性的变异等位基因(A)在超重糖尿病患者中具有更好的人体测量学参数。A等位基因携带者在接受利拉鲁肽治疗后体重和脂肪量下降幅度更大。本研究是一项初步观察,其结果需要在不同人群中纳入更多患者进行重复验证。