Department of Endocrinology, Changi General Hospital, Singapore, Singapore.
Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore.
Diabetes Obes Metab. 2017 Dec;19(12):1814-1817. doi: 10.1111/dom.13007. Epub 2017 Jul 14.
We compared the effects of weight loss induced by the glucagon-like peptide 1-agonist liraglutide with a structured lifestyle intervention in obese adults with non-alcoholic fatty liver disease (NAFLD). Obese (body mass index ≥30 kg/m , mean weight 96.0 ± 16.3 kg) non-diabetic Asian adults, with NAFLD diagnosed by liver fat fraction (LFF) ≥ 5.5% on magnetic resonance imaging without other causes of hepatic steatosis, were randomized to a supervised program of dieting (restriction by 400 kilocalories/d) plus moderate-intensity aerobic exercise (~200 min/wk; DE group, n = 12), or liraglutide at the 3 mg daily dose approved for weight loss (LI group, n = 12), for 26 weeks. Both DE and LI groups had significant (P < .01) and similar reductions in weight (-3.5 ± 3.3 vs -3.5 ± 2.1 kg, respectively, P = .72), LFF (-8.9 ± 13.4 vs -7.2% ± 7.1%, P = .70), serum alanine aminotransferase (-42 ± 46 vs -34 ± 27 U/L, P = .52) and aspartate aminotransferase (-23 ± 24 vs -18 ± 15 U/L, P = .53). In this first randomized study comparing the 2 weight-loss modalities for improving NAFLD, liraglutide was as effective as structured lifestyle modification.
我们比较了胰高血糖素样肽 1 激动剂利拉鲁肽引起的体重减轻与肥胖的非酒精性脂肪性肝病(NAFLD)患者结构化生活方式干预的效果。肥胖(体重指数≥30kg/m ,平均体重 96.0±16.3kg)的非糖尿病亚洲成年人,通过磁共振成像诊断为非酒精性脂肪性肝病(NAFLD),肝脂肪分数(LFF)≥5.5%,无其他原因引起的肝脂肪变性,随机分为节食(限制 400 千卡/天)加中等强度有氧运动(~200 分钟/周;DE 组,n=12)或利拉鲁肽(每日 3mg,批准用于减肥;LI 组,n=12),为期 26 周。DE 和 LI 两组体重均显著(P<.01)且相似减轻(分别为-3.5±3.3kg 和-3.5±2.1kg,P=0.72),LFF 减少(-8.9±13.4%和-7.2%±7.1%,P=0.70),血清丙氨酸氨基转移酶(-42±46U/L 和-34±27U/L,P=0.52)和天冬氨酸氨基转移酶(-23±24U/L 和-18±15U/L,P=0.53)。在第一项比较两种减肥方式改善非酒精性脂肪性肝病的随机研究中,利拉鲁肽与结构化生活方式改变一样有效。