Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
Liverpool University Hospitals NHS Foundation Trust, University Hospital Aintree, Liverpool, UK.
Diabetes Obes Metab. 2023 Dec;25(12):3621-3631. doi: 10.1111/dom.15257. Epub 2023 Sep 5.
This study assessed the impact of dapagliflozin on food intake, eating behaviour, energy expenditure, magnetic resonance imaging (MRI)-determined brain response to food cues and body composition in patients with type 2 diabetes mellitus (T2D).
Patients were given dapagliflozin 10 mg once daily in a randomized, double-blind, placebo-controlled trial with short-term (1 week) and long-term (12 weeks) cross-over periods. The primary outcome was the difference in test meal food intake between long-term dapagliflozin and placebo treatment. Secondary outcomes included short-term differences in test meal food intake, short- and long-term differences in appetite and eating rate, energy expenditure and functional MRI brain activity in relation to food images. We determined differences in glycated haemoglobin, weight, liver fat (by H magnetic resonance spectroscopy) and subcutaneous/visceral adipose tissue volumes (by MRI).
In total, 52 patients (43% were women) were randomized; with the analysis of 49 patients: median age 58 years, weight 99.1 kg, body mass index 35 kg/m , glycated haemoglobin 49 mmol/mol. Dapagliflozin reduced glycated haemoglobin by 9.7 mmol/mol [95% confidence interval (CI) 3.91-16.27, p = .004], and body weight (-2.84 vs. -0.87 kg) versus placebo. There was no short- or long-term difference in test meal food intake between dapagliflozin and placebo [mean difference 5.7 g (95% CI -127.9 to 139.3, p = .933); 15.8 g (95% CI -147.7 to 116.1, p = .813), respectively] nor in the rate of eating, energy expenditure, appetite, or brain responses to food cues. Liver fat (median reduction -4.7 vs. 1.95%), but not subcutaneous/visceral adipose tissue, decreased significantly with 12 weeks of dapagliflozin.
The reduction in body weight and liver fat with dapagliflozin was not associated with compensatory adaptations in food intake or energy expenditure.
本研究评估了达格列净对 2 型糖尿病（T2D）患者的食物摄入、进食行为、能量消耗、磁共振成像（MRI）确定的食物线索反应以及身体成分的影响。
患者接受达格列净 10mg 每日一次的随机、双盲、安慰剂对照试验，具有短期（1 周）和长期（12 周）交叉期。主要结局是长期达格列净与安慰剂治疗之间试验餐食物摄入的差异。次要结局包括试验餐食物摄入的短期差异、短期和长期食欲和进食率、能量消耗以及与食物图像相关的功能 MRI 脑活动的差异。我们确定了糖化血红蛋白、体重、肝脏脂肪（通过 H 磁共振波谱）和皮下/内脏脂肪组织体积（通过 MRI）的差异。
共有 52 名患者（43%为女性）被随机分组；对 49 名患者进行了分析：中位年龄 58 岁，体重 99.1kg，体重指数 35kg/m ，糖化血红蛋白 49mmol/mol。达格列净降低糖化血红蛋白 9.7mmol/mol[95%置信区间（CI）3.91-16.27，p=0.004]，体重（-2.84 与-0.87kg）与安慰剂相比。达格列净与安慰剂之间在试验餐食物摄入方面无短期或长期差异[平均差异 5.7g（95%CI-127.9 至 139.3，p=0.933）；15.8g（95%CI-147.7 至 116.1，p=0.813）]，也无进食速度、能量消耗、食欲或对食物线索的大脑反应差异。肝脏脂肪（中位数降低-4.7 与 1.95%）显著降低，但皮下/内脏脂肪组织无明显变化，达格列净治疗 12 周后。
达格列净降低体重和肝脏脂肪与食物摄入或能量消耗的代偿性适应无关。
