利拉鲁肽对2型糖尿病超重和肥胖患者身体成分、食欲依从性及血脂水平的24周影响。
Twenty-four-week effects of liraglutide on body composition, adherence to appetite, and lipid profile in overweight and obese patients with type 2 diabetes mellitus.
作者信息
Rondanelli Mariangela, Perna Simone, Astrone Paolo, Grugnetti Annalisa, Solerte Sebastiano Bruno, Guido Davide
机构信息
Endocrinology and Nutrition Unit, Section of Human Nutrition, Department of Public Health, Experimental and Forensic Medicine, Agency for Elderly People Services, Santa Margherita Hospital, University of Pavia, Pavia, Italy.
Section of Geriatrics and Gerontology, Department of Internal Medicine, Agency for Elderly People Services, Santa Margherita Hospital, University of Pavia, Pavia, Italy.
出版信息
Patient Prefer Adherence. 2016 Mar 24;10:407-13. doi: 10.2147/PPA.S97383. eCollection 2016.
BACKGROUND
Liraglutide has well-known effects on glucose patterns. However, its several other metabolic properties are still controversial. Given this background, the aims of the present study are to evaluate the effects of 24-week liraglutide treatment on body composition, appetite, and lipid profile in overweight and obese type 2 diabetes mellitus (T2DM) patients.
METHODS
A cohort study was carried out on overweight and obese T2DM patients with glycosylated hemoglobin A1c equal to 6% (42 mmol/mol)-10% (86 mmol/mol), under a 3-month treatment (at least) with maximal dose of metformin as stable regime, by adding liraglutide at doses up to 3 mg/d. Body composition markers were measured by dual-energy X-ray densitometry at baseline and after 24 weeks of liraglutide treatment. Glucose control was monitored by glucose, glycosylated hemoglobin A1c, insulin, and homeostasis model assessment. Finally, the appetite sensation and plasma lipids were also evaluated.
RESULTS
Twenty-eight subjects (male/female: 16/12, mean age: 58.75±9.33 years, body mass index: 34.13±5.46 kg/m(2)) were evaluated. Accounting for the adjustment for age, sex, and duration of diabetes, we noted significant decreases in body mass index (-0.86 kg/m(2), P=0.024), fat mass (-2.01 kg, P=0.015), fat mass index (-0.71 kg/m(2), P=0.014), android fat (-1.72%, P=0.022), trunk fat (-1.52%, P=0.016), and waist circumference (-6.86 cm, P<0.001) from the baseline values. Haber score was increased by 3.82 units (P=0.009), and the number of metabolic syndrome risk factors was decreased (-0.69 units, P=0.012). The glucose control variables and total cholesterol/high-density lipoprotein cholesterol ratio also showed significant decreases from baseline values.
CONCLUSION
The 24-week liraglutide treatment leads to the reduction of fat mass, android fat, trunk fat, and appetite by improving the lipid profile, glucose control, and insulin sensitivity.
背景
利拉鲁肽对血糖模式有众所周知的影响。然而，其其他一些代谢特性仍存在争议。鉴于此背景，本研究的目的是评估超重和肥胖2型糖尿病（T2DM）患者接受24周利拉鲁肽治疗对身体成分、食欲和血脂谱的影响。
方法
对糖化血红蛋白A1c等于6%（42 mmol/mol）-10%（86 mmol/mol）的超重和肥胖T2DM患者进行队列研究，这些患者至少接受了3个月最大剂量二甲双胍的稳定治疗，在此基础上添加剂量高达3 mg/d的利拉鲁肽。在基线和利拉鲁肽治疗24周后，通过双能X线骨密度仪测量身体成分指标。通过血糖、糖化血红蛋白A1c、胰岛素和稳态模型评估来监测血糖控制情况。最后，还评估了食欲感觉和血浆脂质。
结果
共评估了28名受试者（男/女：16/12，平均年龄：58.75±9.33岁，体重指数：34.13±5.46 kg/m²）。在对年龄、性别和糖尿病病程进行校正后，我们发现体重指数（-0.86 kg/m²，P=0.024）、脂肪量（-2.01 kg，P=0.015）、脂肪量指数（-0.71 kg/m²，P=0.014）、腹部脂肪（-1.72%，P=0.022）、躯干脂肪（-1.52%，P=0.016）和腰围（-6.86 cm，P<0.001）较基线值显著降低。哈伯评分增加了3.82个单位（P=0.009），代谢综合征风险因素数量减少（-0.69个单位，P=0.012）。血糖控制变量和总胆固醇/高密度脂蛋白胆固醇比值也较基线值显著降低。
结论
24周利拉鲁肽治疗通过改善血脂谱、血糖控制和胰岛素敏感性，导致脂肪量、腹部脂肪、躯干脂肪减少以及食欲下降。
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