Department of Internal Medicine, Division of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Internal Medicine, Division of General Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
J Diabetes Investig. 2019 Sep;10(5):1254-1261. doi: 10.1111/jdi.13015. Epub 2019 Mar 28.
AIMS/INTRODUCTION: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors improve blood glucose control, as well as reducing bodyweight by promoting urinary glucose excretion. The weight loss is less than expected from urinary glucose loss, however, likely because of an increase in food intake. To investigate whether SGLT-2 inhibitors might increase appetite by affecting related hormones, we examined the effects of the SGLT-2 inhibitor, ipragliflozin, including those on appetite-regulating hormones, in individuals with suboptimally controlled type 2 diabetes.
The present prospective, multicenter, open-label study was carried out with 96 patients with a body mass index of ≥22 kg/m who were treated with ipragliflozin (50 mg/day) for 16 weeks. Parameters including glycated hemoglobin level, bodyweight, circulating leptin and active ghrelin concentrations, and appetite as assessed with a visual analog scale were measured before and during treatment.
Both glycated hemoglobin level (from 7.9 ± 0.8 to 7.1 ± 0.7%) and bodyweight (from 75.2 ± 12.6 to 72.6 ± 12.4 kg) were significantly decreased after treatment for 16 weeks. The fasting serum leptin level was significantly decreased after 2 weeks (from 19.5 ± 13.1 to 18.1 ± 12.4 ng/mL) and remained decreased up to 16 weeks, even after adjustment for bodyweight, whereas the plasma active ghrelin level showed no significant change. The visual analog scale score for hunger was significantly increased at 2 and 8 weeks.
The present results suggest that ipragliflozin improved glycemic control and reduced bodyweight, but also reduced serum leptin levels and might thereby have increased appetite.
目的/引言:钠-葡萄糖共转运蛋白 2(SGLT-2)抑制剂通过促进尿糖排泄来改善血糖控制,并减轻体重。然而,体重减轻的幅度小于尿糖丢失量,这可能是由于食物摄入量增加所致。为了研究 SGLT-2 抑制剂是否会通过影响相关激素来增加食欲,我们检查了 SGLT-2 抑制剂伊格列净对血糖控制不佳的 2 型糖尿病患者的影响,包括对食欲调节激素的影响。
本前瞻性、多中心、开放标签研究纳入了 96 名体重指数(BMI)≥22kg/m²的患者,他们接受伊格列净(50mg/天)治疗 16 周。在治疗前和治疗期间测量了糖化血红蛋白水平、体重、循环瘦素和活性胃饥饿素浓度以及通过视觉模拟评分评估的食欲等参数。
治疗 16 周后,糖化血红蛋白水平(从 7.9±0.8 降至 7.1±0.7%)和体重(从 75.2±12.6 降至 72.6±12.4kg)均显著降低。空腹血清瘦素水平在治疗 2 周后(从 19.5±13.1 降至 18.1±12.4ng/mL)显著降低,并持续至 16 周,即使在调整体重后也是如此,而血浆活性胃饥饿素水平无显著变化。饥饿感的视觉模拟评分在 2 周和 8 周时显著增加。
本研究结果表明,伊格列净改善了血糖控制并减轻了体重,但也降低了血清瘦素水平,可能因此增加了食欲。