Da Porto Andrea, Casarsa Viviana, Colussi Gianluca, Catena Cristiana, Cavarape Alessandro, Sechi Leonardo
Internal Medicine, University of Udine, Italy.
Internal Medicine, University of Udine, Italy.
Diabetes Metab Syndr. 2020 Jul-Aug;14(4):289-292. doi: 10.1016/j.dsx.2020.03.009. Epub 2020 Mar 31.
Binge eating disorder (BED) is the most common eating disorder in the United States and Europe and is associated with obesity and type 2 diabetes (T2D). Presence and severity of BED have been associated with worse metabolic control and greater BMI in T2D patients. Glucagon Like Peptide-1 (GLP1) receptors are present in central nervous system areas involved in appetite regulation and treatment with GLP-1 receptor agonists modulates appetite and reward-related brain areas in humans. We evaluated the effects of treatment with dulaglutide on eating behavior in T2D outpatients with BED.
This was a pilot open label, prospective controlled study. Inclusion criteria were: Age ≤65, HbA1c between 7.5 and 9% on metformin therapy alone, normal renal function and diagnosis of BED. Patients were randomly assigned to receive either Dulaglutide 1,5 mg/sett or Gliclazide 60 mg for 12 weeks. We evaluated baseline binge eating scale score (BES), weight, BMI, percentage fat mass, HbA1c and their changes after treatment. A multivariate linear regression model was used to verify the association between Δ BES from baseline with Δ Hba1c and variation of anthropometric parameters after treatment.
After 12 weeks patients treated with dulaglutide had grater reduction of binge eating behaviour (p < 0.0001), body weight (p < 0,0001), BMI (p < 0.0001), percentage fat mass (p < 0.0001) and HbA1c (p = 0.009) than patients treated with gliclazide. Reduction in BES was associated with reduction in body weight (p < 0.0001) and HbA1c (p = 0.033).
Dulaglutide treatment reduces binge eating behaviour in T2D patients with BED.
暴饮暴食症（BED）是美国和欧洲最常见的饮食失调症，与肥胖症和2型糖尿病（T2D）相关。BED的存在和严重程度与T2D患者较差的代谢控制和更高的体重指数（BMI）有关。胰高血糖素样肽-1（GLP1）受体存在于参与食欲调节的中枢神经系统区域，用GLP-1受体激动剂治疗可调节人类的食欲和与奖赏相关的脑区。我们评估了度拉糖肽治疗对患有BED的T2D门诊患者饮食行为的影响。
这是一项开放性标签的前瞻性对照试验研究。纳入标准为：年龄≤65岁，仅接受二甲双胍治疗时糖化血红蛋白（HbA1c）在7.5%至9%之间，肾功能正常且诊断为BED。患者被随机分配接受1.5mg/周的度拉糖肽或60mg的格列齐特治疗12周。我们评估了基线暴饮暴食量表评分（BES）、体重、BMI、体脂百分比、HbA1c及其治疗后的变化。使用多元线性回归模型来验证治疗后基线BES的变化与HbA1c变化以及人体测量参数变化之间的关联。
治疗12周后，与接受格列齐特治疗的患者相比，接受度拉糖肽治疗的患者在暴饮暴食行为（p<0.0001）、体重（p<0.0001）、BMI（p<0.0001）、体脂百分比（p<0.0001）和HbA1c（p=0.009）方面的降低幅度更大。BES的降低与体重（p<0.0001）和HbA1c（p=0.033）的降低相关。
度拉糖肽治疗可减少患有BED的T2D患者的暴饮暴食行为。
