Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523, USA.
Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO 80523, USA.
Nutrients. 2020 Feb 18;12(2):510. doi: 10.3390/nu12020510.
Sedentary obesity is associated with increased risk of many cardio-metabolic diseases, including type 2 diabetes. Weight loss is therefore a desirable goal for sedentary adults with obesity. Weight loss is also a well-documented side effect of sodium glucose co-transporter 2 (SGLT2) inhibition, a pharmaceutical strategy for diabetes treatment. We hypothesized that, compared with placebo, SGLT2 inhibition as an adjunct to out-patient dietary counselling for weight loss would lead to more favorable modification of body mass and composition, and greater improvement in glucose regulation and lipid profile. Using a randomized, double-blind, repeated measures parallel design, 50 sedentary men and women (body mass index: 33.4 ± 4.7 kg/m; mean ± SD) were assigned to 12 weeks of dietary counselling, supplemented with daily ingestion of either a placebo or SGLT2 inhibitor (dapagliflozin: up to 10 mg/day). Dietary counselling favorably modified body mass, body fat, glucose regulation, and fasting concentrations of triglyceride and very low-density lipoprotein cholesterol (main effects of counselling: < 0.05); SGLT2 inhibition did not influence any of these adaptations (counselling × medication interactions: > 0.05). However, SGLT2 inhibition when combined with dietary counselling led to greater loss of fat-free mass (counselling × medication interaction: = 0.047) and attenuated the rise in high-density lipoprotein cholesterol (counselling × medication interaction: = 0.028). In light of these data and the health implications of decreased fat-free mass, we recommend careful consideration before implementing SGLT2 inhibition as an adjunct to dietary counselling for weight loss in sedentary adults with obesity.
久坐肥胖与许多心血管代谢疾病的风险增加有关，包括 2 型糖尿病。因此，对于肥胖的久坐成年人来说，减肥是一个理想的目标。减肥也是钠-葡萄糖共转运蛋白 2（SGLT2）抑制的一个有充分记录的副作用，SGLT2 抑制是一种治疗糖尿病的药物策略。我们假设，与安慰剂相比，SGLT2 抑制作为门诊饮食咨询减肥的辅助手段，将导致更有利的体重和成分的改变，以及更好地改善葡萄糖调节和血脂谱。使用随机、双盲、重复测量平行设计，将 50 名久坐的男性和女性（体重指数：33.4 ± 4.7 kg/m；平均值 ± SD）分为 12 周的饮食咨询组，补充每日服用安慰剂或 SGLT2 抑制剂（达格列净：高达 10 mg/天）。饮食咨询有利地改变了体重、体脂肪、葡萄糖调节以及空腹甘油三酯和极低密度脂蛋白胆固醇浓度（咨询的主要效果： < 0.05）；SGLT2 抑制对这些适应没有影响（咨询 × 药物相互作用： > 0.05）。然而，当 SGLT2 抑制与饮食咨询结合使用时，会导致更多的去脂体重丢失（咨询 × 药物相互作用： = 0.047），并减轻高密度脂蛋白胆固醇的升高（咨询 × 药物相互作用： = 0.028）。鉴于这些数据以及去脂体重减少的健康影响，我们建议在肥胖的久坐成年人中，将 SGLT2 抑制作为饮食咨询减肥的辅助手段之前，要仔细考虑。
