Department of Medicine, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
Diabetes Metab J. 2020 Apr;44(2):248-259. doi: 10.4093/dmj.2019.0018. Epub 2019 Nov 4.
To investigate the effects of a glucagon-like peptide-1 receptor agonist on functional brain activation in lean and obese individuals with type 2 diabetes mellitus (T2DM) in response to visual food cues.
In a randomized, single-blinded, crossover study, 15 lean and 14 obese individuals with T2DM were administered lixisenatide or normal saline subcutaneously with a 1-week washout period. We evaluated brain activation in response to pictures of high-calorie food, low-calorie food, and nonfood using functional magnetic resonance imaging and measured appetite and caloric intake in participants who were given access to an buffet.
Obese individuals with T2DM showed significantly greater activation of the hypothalamus, pineal gland, parietal cortex (high-calorie food vs. low-calorie food, <0.05), orbitofrontal cortex (high-calorie food vs. nonfood, <0.05), and visual cortex (food vs. nonfood, <0.05) than lean individuals with T2DM. Lixisenatide injection significantly reduced the functional activation of the fusiform gyrus and lateral ventricle in obese individuals with T2DM compared with that in lean individuals with T2DM (nonfood vs. high-calorie food, <0.05). In addition, in individuals who decreased their caloric intake after lixisenatide injection, there were significant interaction effects between group and treatment in the posterior cingulate, medial frontal cortex (high-calorie food vs. low-calorie food, <0.05), hypothalamus, orbitofrontal cortex, and temporal lobe (food vs. nonfood, <0.05).
Brain responses to visual food cues were different in lean and obese individuals with T2DM. In addition, acute administration of lixisenatide differentially affected functional brain activation in these individuals, especially in those who decreased their caloric intake after lixisenatide injection.
研究胰高血糖素样肽-1 受体激动剂对 2 型糖尿病（T2DM）瘦人和肥胖个体在视觉食物线索刺激下的大脑功能激活的影响。
在一项随机、单盲、交叉研究中，15 名瘦人和 14 名肥胖 T2DM 患者分别皮下注射利西那肽或生理盐水，洗脱期为 1 周。我们使用功能磁共振成像评估了参与者在看到高热量食物、低热量食物和非食物图片时的大脑激活情况，并在参与者可以自由选择自助餐的情况下测量了他们的食欲和卡路里摄入量。
与瘦 T2DM 患者相比，肥胖 T2DM 患者的下丘脑、松果体、顶叶皮层（高热量食物与低热量食物相比，<0.05）、眶额皮层（高热量食物与非食物相比，<0.05）和视觉皮层（食物与非食物相比，<0.05）的激活更为明显。与瘦 T2DM 患者相比，利西那肽注射显著降低了肥胖 T2DM 患者的梭状回和侧脑室的功能激活（非食物与高热量食物相比，<0.05）。此外，在利西那肽注射后减少热量摄入的个体中，在后扣带回、内侧前额皮质（高热量食物与低热量食物相比，<0.05）、下丘脑、眶额皮质和颞叶（食物与非食物相比，<0.05）中，存在组间和治疗间的显著交互作用。
瘦人和肥胖 T2DM 患者对视觉食物线索的大脑反应不同。此外，利西那肽的急性给药对这些个体的大脑功能激活产生了不同的影响，尤其是在利西那肽注射后减少热量摄入的个体中。
