Department of Psychology, University of Leeds, Leeds, UK.
Novo Nordisk, Søborg, Denmark.
Diabetes Obes Metab. 2017 Sep;19(9):1242-1251. doi: 10.1111/dom.12932. Epub 2017 May 5.
The aim of this trial was to investigate the mechanism of action for body weight loss with semaglutide.
This randomised, double-blind, placebo-controlled, two-period crossover trial investigated the effects of 12 weeks of treatment with once-weekly subcutaneous semaglutide, dose-escalated to 1.0 mg, in 30 subjects with obesity. Ad libitum energy intake, ratings of appetite, thirst, nausea and well-being, control of eating, food preference, resting metabolic rate, body weight and body composition were assessed.
After a standardised breakfast, semaglutide, compared with placebo, led to a lower ad libitum energy intake during lunch (-1255 kJ; P < .0001) and during the subsequent evening meal ( P = .0401) and snacks ( P = .0034), resulting in a 24% reduction in total energy intake across all ad libitum meals throughout the day (-3036 kJ; P < .0001). Fasting overall appetite suppression scores were improved with semaglutide vs placebo, while nausea ratings were similar. Semaglutide was associated with less hunger and food cravings, better control of eating and a lower preference for high-fat foods. Resting metabolic rate, adjusted for lean body mass, did not differ between treatments. Semaglutide led to a reduction from baseline in mean body weight of 5.0 kg, predominantly from body fat mass.
After 12 weeks of treatment, ad libitum energy intake was substantially lower with semaglutide vs placebo with a corresponding loss of body weight observed with semaglutide. In addition to reduced energy intake, likely mechanisms for semaglutide-induced weight loss included less appetite and food cravings, better control of eating and lower relative preference for fatty, energy-dense foods.
本试验旨在研究司美格鲁肽减轻体重的作用机制。
这是一项随机、双盲、安慰剂对照、两周期交叉试验，纳入 30 例肥胖患者，研究了为期 12 周的每周一次皮下注射司美格鲁肽（剂量递增至 1.0mg）治疗的效果。评估了自由饮食摄入、食欲、口渴、恶心和幸福感评分、进食控制、食物偏好、静息代谢率、体重和身体成分。
与安慰剂相比，标准早餐后，司美格鲁肽可降低午餐时（-1255kJ；P<0.0001）和随后晚餐时（P=0.0401）及零食时（P=0.0034）的自由饮食摄入，导致全天所有自由饮食摄入中总能量摄入减少 24%（-3036kJ；P<0.0001）。与安慰剂相比，司美格鲁肽可改善空腹时整体食欲抑制评分，而恶心评分相似。司美格鲁肽与饥饿感和食物渴求减少、进食控制改善和对高脂肪食物的偏好降低相关。调整瘦体重后，两种治疗方法的静息代谢率无差异。司美格鲁肽可使平均体重较基线降低 5.0kg，主要来自体脂肪量。
治疗 12 周后，与安慰剂相比，司美格鲁肽的自由饮食摄入量明显降低，且观察到司美格鲁肽治疗可使体重下降。除了能量摄入减少外，司美格鲁肽引起体重下降的可能机制还包括食欲和食物渴求减少、进食控制改善和对高脂肪、高能量食物的相对偏好降低。
