Novo Nordisk A/S, Søborg, Denmark.
Covance Clinical Research Unit Ltd, Leeds, UK.
Diabetes Obes Metab. 2018 Mar;20(3):610-619. doi: 10.1111/dom.13120. Epub 2017 Oct 27.
To investigate the effects of semaglutide on fasting and postprandial glucose and lipid responses, and on gastric emptying.
This was a randomized, double-blind, placebo-controlled, 2-period, crossover trial. Subjects with obesity (N = 30) received once-weekly subcutaneous semaglutide, dose-escalated to 1.0 mg, or placebo. After each 12-week treatment period, glucose and lipid metabolism were assessed before and after standardized meals. Gastric emptying (paracetamol absorption test) and peptide YY (PYY) response were also assessed.
Semaglutide treatment significantly lowered fasting concentrations of glucose and glucagon, and increased insulin vs placebo (estimated treatment ratio: 0.95 [95% confidence interval: 0.91, 0.98]; 0.86 [0.75, 0.98]; 1.45 [1.20, 1.75], respectively). Postprandial glucose metabolism significantly improved with semaglutide vs placebo (incremental area under the curve 0 to 5 hours [iAUC ]; estimated treatment difference: glucose -1.34 mmol h/L [-2.42, -0.27]; insulin -921 pmol h/L [-1461, -381]; C-peptide -1.42 nmol h/L [-2.33, -0.51]). Fasting and postprandial lipid metabolism improved with semaglutide vs placebo. First-hour gastric emptying after the meal was delayed with semaglutide vs placebo (AUC ; estimated treatment ratio: 0.73 [0.61, 0.87]); this may have contributed to the lower postprandial glucose increase in semaglutide-treated subjects. Overall gastric emptying (AUC ) was not statistically different between treatments. Fasting and postprandial PYY responses were significantly lower with semaglutide vs placebo (P = .0397 and P = .0097, respectively).
Semaglutide improved fasting and postprandial glucose and lipid metabolism. Overall gastric emptying was similar to that with placebo; however, the observed first-hour delay with semaglutide may contribute to a slower entry of glucose into the circulation.
研究司美格鲁肽对空腹和餐后血糖及血脂的影响，以及对胃排空的影响。
这是一项随机、双盲、安慰剂对照、2 期交叉试验。30 名肥胖受试者接受每周一次皮下注射司美格鲁肽，剂量递增至 1.0mg，或安慰剂。在每 12 周的治疗期后，在标准餐前后评估葡萄糖和脂质代谢。还评估了胃排空（对乙酰氨基酚吸收试验）和肽 YY（PYY）反应。
与安慰剂相比，司美格鲁肽治疗显著降低了空腹血糖和胰高血糖素浓度，并增加了胰岛素（估计治疗比值：0.95[95%置信区间：0.91，0.98]；0.86[0.75，0.98]；1.45[1.20，1.75]）。与安慰剂相比，司美格鲁肽显著改善了餐后血糖代谢（0 至 5 小时的增量 AUC[ iAUC]；估计治疗差异：葡萄糖-1.34mmol h/L[-2.42，-0.27]；胰岛素-921pmol h/L[-1461，-381]；C 肽-1.42nmol h/L[-2.33，-0.51]）。与安慰剂相比，空腹和餐后血脂代谢也得到了改善。与安慰剂相比，司美格鲁肽治疗后餐后 1 小时胃排空延迟（AUC；估计治疗比值：0.73[0.61，0.87]）；这可能导致司美格鲁肽治疗组餐后血糖升高较低。两种治疗方法的总体胃排空（AUC）无统计学差异。与安慰剂相比，司美格鲁肽治疗后的空腹和餐后 PYY 反应明显降低（P=0.0397 和 P=0.0097）。
司美格鲁肽改善了空腹和餐后血糖及血脂代谢。与安慰剂相比，总体胃排空相似；然而，观察到的司美格鲁肽 1 小时延迟可能导致葡萄糖更缓慢地进入循环。
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