Internal Medicine, Kanagawa Dental University, Yokosuka, Japan.
Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Endocr J. 2020 Sep 28;67(9):957-962. doi: 10.1507/endocrj.EJ19-0464. Epub 2020 Jun 16.
The mechanism for the cholesterol-lowering effect of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) remains unknown in patients with type 2 diabetes. We evaluated the effect of liraglutide on serum lipid profiles, including cholesterol synthesis and absorption markers, during daily clinical practice in Japanese patients with type 2 diabetes. We enrolled 38 patients with type 2 diabetes mellitus who were not treated with a GLP-1 RA (≥20 years of age, HbA1c ≥6.5%). Liraglutide, a GLP-1 RA, was administered subcutaneously once a day for three months to these patients. Blood samples and body weights were collected at 0, 1, and 3 months. Total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) at 1 month, and non-high-density lipoprotein cholesterol (non-HDL-C) and calculated TC at 1 and 3 months, were decreased, while the cholesterol synthesis and cholesterol absorption markers were unchanged by this treatment. In patients with LDL-C levels over 100 mg/dL, LDL-C, non-HDL-C, TC, and calculated TC levels were decreased significantly by the treatment at 1 and 3 months, and the cholesterol absorption marker, campesterol, was decreased at 3 months. The administration of liraglutide for 3 months decreased non-HDL-C and calculated TC significantly, while the cholesterol synthesis and absorption markers were not changed by this treatment.
GLP-1 受体激动剂（GLP-1 RAs）降低胆固醇的作用机制在 2 型糖尿病患者中尚不清楚。我们评估了利拉鲁肽在日本 2 型糖尿病患者日常临床实践中对血脂谱（包括胆固醇合成和吸收标志物）的影响。我们纳入了 38 名未接受 GLP-1 RA 治疗的 2 型糖尿病患者（≥20 岁，HbA1c≥6.5%）。这些患者接受利拉鲁肽皮下注射，每天一次，持续 3 个月。在 0、1 和 3 个月时采集血样和体重。1 个月时 TC 和 LDL-C 降低，1 和 3 个月时非 HDL-C 和计算 TC 降低，而胆固醇合成和胆固醇吸收标志物不受此治疗影响。在 LDL-C 水平超过 100mg/dL 的患者中，治疗 1 和 3 个月后 LDL-C、非 HDL-C、TC 和计算 TC 水平显著降低，3 个月时胆固醇吸收标志物坎培醇降低。利拉鲁肽治疗 3 个月可显著降低非 HDL-C 和计算 TC，而胆固醇合成和吸收标志物不受此治疗影响。
