Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.
Obesity (Silver Spring). 2022 Aug;30(8):1608-1620. doi: 10.1002/oby.23481.
OBJECTIVE: This study aimed to determine the effects of a long-acting glucagon-like peptide-1 (GLP-1) receptor agonist, liraglutide, and placebo subcutaneously over 16 weeks on weight and gastric functions and to evaluate associations of single-nucleotide polymorphisms in GLP1R (rs6923761) and TCF7L2 (rs7903146) with effects of liraglutide. METHODS: The study conducted a randomized, parallel-group, placebo-controlled, 16-week trial of liraglutide, escalated to 3 mg subcutaneously daily in 136 otherwise healthy adults with obesity. Weight, gastric emptying of solids (GES), gastric volumes, satiation, and body composition measured at baseline and after treatment were compared in two treatment groups using analysis of covariance. RESULTS: Liraglutide (n = 59) and placebo (n = 65) groups completed treatment. Relative to placebo, liraglutide increased weight loss at 5 and 16 weeks (both p < 0.05), slowed time to half GES (T ) at 5 and 16 weeks (both p < 0.001), and increased fasting gastric volume (p = 0.01) and satiation (p < 0.01) at 16 weeks. GES T was positively correlated with weight loss on liraglutide (both p < 0.001). After 16 weeks of liraglutide, GLP1R rs6923761 (AG/AA vs. GG) was associated with reduced percent body fat (p = 0.062), and TCF7L2 rs7903146 (CC vs. CT/TT) was associated with lower body weight (p = 0.015). CONCLUSIONS: Liraglutide, 3 mg, induces weight loss with delay in GES T and reduces calorie intake. Slowing GES and variations in GLP1R and TCF7L2 are associated with liraglutide effects in obesity.
目的:本研究旨在确定长效胰高血糖素样肽-1(GLP-1)受体激动剂利拉鲁肽皮下注射 16 周对体重和胃功能的影响,并评估 GLP1R(rs6923761)和 TCF7L2(rs7903146)单核苷酸多态性与利拉鲁肽作用的相关性。
方法:本研究进行了一项随机、平行组、安慰剂对照、16 周的利拉鲁肽试验,共纳入 136 名健康肥胖成年人,皮下递增剂量至 3 mg 每日 1 次。采用协方差分析比较两组治疗前后体重、固体胃排空(GES)、胃容量、饱腹感和身体成分的变化。
结果:利拉鲁肽组(n=59)和安慰剂组(n=65)均完成了治疗。与安慰剂相比,利拉鲁肽在 5 周和 16 周时体重减轻(均 p<0.05),5 周和 16 周时 GES T 减半时间延长(均 p<0.001),空腹胃容量增加(p=0.01),饱腹感增强(p<0.01)。GES T 与利拉鲁肽治疗时体重减轻呈正相关(均 p<0.001)。利拉鲁肽治疗 16 周后,GLP1R rs6923761(AG/AA 与 GG)与体脂肪百分比降低相关(p=0.062),TCF7L2 rs7903146(CC 与 CT/TT)与体重降低相关(p=0.015)。
结论:利拉鲁肽 3 mg 可诱导体重减轻,GES T 延迟,并减少热量摄入。GES 减慢以及 GLP1R 和 TCF7L2 的变化与肥胖患者利拉鲁肽的作用相关。
Obesity (Silver Spring). 2022-8
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