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使用利拉鲁肽进行治疗可能会通过降低载脂蛋白B水平来改善心血管疾病(CVD)的标志物。

Treatment with liraglutide may improve markers of CVD reflected by reduced levels of apoB.

作者信息

Engelbrechtsen L, Lundgren J, Wewer Albrechtsen N J, Mahendran Y, Iepsen E W, Finocchietto P, Jonsson A E, Madsbad S, Holst J J, Vestergaard H, Hansen T, Torekov S S

机构信息

NNF Center for Basic Metabolic Research, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark.

The Danish Diabetes Academy Odense Denmark.

出版信息

Obes Sci Pract. 2017 Nov 21;3(4):425-433. doi: 10.1002/osp4.133. eCollection 2017 Dec.

Abstract

BACKGROUND

Dislipidaemia and increased levels of apolipoprotein B (apoB) in individuals with obesity are risk factors for development of cardiovascular disease (CVD). The aim of this study was to investigate the effect of weight loss and weight maintenance with and without liraglutide treatment on plasma lipid profiles and apoB.

METHODS

Fifty-eight individuals with obesity (body mass index 34.5 ± 3.0 kg/m [mean ± SD]) were included in this study. After 8 weeks on a very low-calorie diet (800 kcal/day), participants were randomized to weight maintenance with meal replacements with or without liraglutide (1.2 mg daily) for 1 year. Plasma samples from before and after weight loss and after 1 year of weight maintenance were subjected to nuclear magnetic resonance-based lipidomics analysis.

RESULTS

After an 8-week low-calorie diet, study participants lost 12.0 ± 2.9 kg (mean ± SD) of their body weight, which was reflected in their lipid profiles (80 out of 124 lipids changed significantly), including reduced levels of apoB, total cholesterol, free cholesterol, remnant cholesterol, triglycerides, low-density lipoprotein and very low-density lipoprotein subclasses. After 1 year of maintained weight loss, the majority of the lipids had returned to pre-weight loss levels even though weight loss was successfully maintained in both groups. Interestingly, apoB levels remained low in the liraglutide treated group (apoB change: 0.03 ± 0.02 mmol/L, p = 0.4) in contrast to an increase in the control group (apoB change: 0.06 ± 0.07 mmol/L, p = 0.02).

CONCLUSION

An 8-week low-calorie diet, in individuals with obesity, reduced plasma levels of lipids and the atherogenic marker apoB. After 1 year of weight maintenance, only study participants treated with liraglutide maintained reduced levels of apoB, despite similar body weight maintenance. Treatment with liraglutide may therefore reduce apoB levels and thus reflect lower CVD risk. Including apoB measurements in clinical practice when monitoring patients with dislipidemia or CVD might prove to be useful.

摘要

背景

肥胖个体的血脂异常和载脂蛋白B(apoB)水平升高是心血管疾病(CVD)发生的危险因素。本研究的目的是调查在有或没有利拉鲁肽治疗的情况下,体重减轻和体重维持对血脂谱和apoB的影响。

方法

本研究纳入了58名肥胖个体(体重指数34.5±3.0kg/m²[平均值±标准差])。在进行8周极低热量饮食(800千卡/天)后,参与者被随机分为接受或不接受利拉鲁肽(每日1.2毫克)的代餐体重维持组,为期1年。对体重减轻前后以及体重维持1年后的血浆样本进行基于核磁共振的脂质组学分析。

结果

经过8周的低热量饮食,研究参与者体重减轻了12.0±2.9千克(平均值±标准差),这反映在他们的血脂谱中(124种脂质中有80种发生了显著变化),包括apoB、总胆固醇、游离胆固醇、残余胆固醇、甘油三酯、低密度脂蛋白和极低密度脂蛋白亚类水平降低。在体重减轻维持1年后,尽管两组体重均成功维持,但大多数脂质已恢复到体重减轻前的水平。有趣的是,与对照组apoB水平升高(apoB变化:0.06±0.07毫摩尔/升,p=0.02)相反,利拉鲁肽治疗组的apoB水平仍保持较低(apoB变化:0.03±0.02毫摩尔/升,p=0.4)。

结论

肥胖个体进行8周的低热量饮食可降低血浆脂质水平和致动脉粥样硬化标志物apoB。在体重维持1年后,尽管体重维持情况相似,但只有接受利拉鲁肽治疗的研究参与者维持了较低的apoB水平。因此,利拉鲁肽治疗可能会降低apoB水平,从而反映较低的CVD风险。在临床实践中监测血脂异常或CVD患者时进行apoB测量可能会被证明是有用的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d179/5729494/2692a58f6706/OSP4-3-425-g001.jpg

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