Psychoinfectivology Service, Pescara General Hospital, Pescara, Italy.
Department of Medicine and Aging, Center of Aging Science and Translational Medicine (CESI-Met), Via Luigi Polacchi, Chieti, Italy.
Int J Obes (Lond). 2020 Jun;44(6):1254-1263. doi: 10.1038/s41366-020-0535-5. Epub 2020 Jan 21.
BACKGROUND/OBJECTIVES: Diabetic subjects are at increased risk of subtle cognitive impairment since the disease early stages and of dementia later in life. In animal models, glucagon-like peptide-1 receptor agonizts (GLP1-RAs) have been shown to exert neuroprotective effects, expecially in the memory domain. We assessed whether treatment with a GLP1-RA might affect cognitive functions in type 2 diabetic subjects independently on the weight loss it might induce.
SUBJECTS/METHODS: Forty metformin-treated obese subjects with prediabetes or newly diagnosed type 2 diabetes mellitus, received liraglutide (1.8 mg/d) (n = 20) or lifestyle counseling (dietary intervention and exercise training) (n = 20) until achieving a modest and comparable weight loss (-7% of initial body weight).
INTERVENTIONS/METHODS: A detailed neuropsychological assessment before and after weight loss was completed in 16 patients per arm, who were administered a total of seven psychological tests, thus assessing three composite domain z-scores for attention, memory, and executive control.
After comparable weight loss and superimposable glycemic control and insulin sensitivity, a significant increase in short term memory (mean Digit Span Z score from -0.06 to 0.80, p = 0.024) and memory composite z-score (mean memory z-score from -0.67 to 0.032, p = 0.0065) was observed in the liraglutide exposed subjects (between group p = 0.041 and p = 0.033, respectively).
Liraglutide might slow down memory function decline in diabetic patients in early, and possibly preclinical stages of the disease.
背景/目的：糖尿病患者在疾病早期就存在认知功能轻度受损的风险，在晚年则存在痴呆的风险。在动物模型中，胰高血糖素样肽-1 受体激动剂（GLP1-RAs）已被证明具有神经保护作用，特别是在记忆领域。我们评估了 GLP1-RA 的治疗是否可能影响 2 型糖尿病患者的认知功能，而与它可能引起的体重减轻无关。
受试者/方法：40 名接受二甲双胍治疗的肥胖前驱糖尿病或新诊断的 2 型糖尿病患者，接受利拉鲁肽（1.8mg/d）（n=20）或生活方式咨询（饮食干预和运动训练）（n=20），直到达到适度且相当的体重减轻（初始体重的-7%）。
干预/方法：在每个治疗组的 16 名患者中完成了减重前后的详细神经心理学评估，他们共接受了七项心理测试，从而评估了注意力、记忆和执行控制三个综合领域的 z 分数。
在可比较的体重减轻和相似的血糖控制和胰岛素敏感性后，利拉鲁肽暴露组的短期记忆（从 -0.06 到 0.80 的平均数字跨度 z 评分，p=0.024）和记忆综合 z 评分（从 -0.67 到 0.032 的平均记忆 z 评分，p=0.0065）显著增加（组间 p=0.041 和 p=0.033）。
利拉鲁肽可能减缓糖尿病患者在疾病早期和可能的临床前阶段记忆功能下降的速度。
