Katsuyama Hisayuki, Hakoshima Mariko, Kaji Emika, Mino Masaaki, Kakazu Eiji, Iida Sakura, Adachi Hiroki, Kanto Tatsuya, Yanai Hidekatsu
Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Kohnodai Hospital, 1-7-1 Kohnodai, Ichikawa 272-8516, Chiba, Japan.
Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine Kohnodai Hospital, 1-7-1 Kohnodai, Ichikawa 272-8516, Chiba, Japan.
Biomedicines. 2024 May 2;12(5):1001. doi: 10.3390/biomedicines12051001.
Once-weekly semaglutide is a widely used glucagon-like peptide-1 receptor agonist (GLP-1RA) used for the treatment of type 2 diabetes (T2D). In clinical trials, semaglutide improved glycemic control and obesity, and reduced major cardiovascular events. However, the reports are limited on its real-world efficacy relating to various metabolic factors such as dyslipidemia or metabolic dysfunction-associated steatotic liver disease (MASLD) in Asian patients with T2D. In our retrospective longitudinal study, we selected patients with T2D who were given once-weekly semaglutide and compared metabolic parameters before and after the start of semaglutide. Seventy-five patients were eligible. HbA1c decreased significantly, by 0.7-0.9%, and body weight by 1.4-1.7 kg during the semaglutide treatment. Non-HDL cholesterol decreased significantly at 3, 6 and 12 months after the initiation of semaglutide; LDL cholesterol decreased at 3 and 6 months; and HDL cholesterol increased at 12 months. The effects on body weight, HbA1c and lipid profile were pronounced in patients who were given semaglutide as a first GLP-1RA (GLP-1R naïve), whereas improvements in HbA1c were also observed in patients who were given semaglutide after being switched from other GLP-1RAs. During a 12-month semaglutide treatment, the hepatic steatosis index (HSI) tended to decrease. Moreover, a significant decrease in the AST-to-platelet ratio index (APRI) was observed in GLP-1RA naïve patients. Our real-world study confirmed the beneficial effects of once-weekly semaglutide, namely, improved body weight, glycemic control and atherogenic lipid profile. The beneficial effects on MASLD were also suggested.
每周一次的司美格鲁肽是一种广泛用于治疗2型糖尿病（T2D）的胰高血糖素样肽-1受体激动剂（GLP-1RA）。在临床试验中，司美格鲁肽改善了血糖控制和肥胖状况，并减少了主要心血管事件。然而，关于其在亚洲T2D患者中与各种代谢因素（如血脂异常或代谢功能障碍相关脂肪性肝病（MASLD））相关的真实疗效的报告有限。在我们的回顾性纵向研究中，我们选择了接受每周一次司美格鲁肽治疗的T2D患者，并比较了司美格鲁肽开始治疗前后的代谢参数。75名患者符合条件。在司美格鲁肽治疗期间，糖化血红蛋白（HbA1c）显著下降了0.7 - 0.9%，体重下降了1.4 - 1.7千克。司美格鲁肽开始使用后3、6和12个月时，非高密度脂蛋白胆固醇显著下降；3和6个月时低密度脂蛋白胆固醇下降；12个月时高密度脂蛋白胆固醇升高。对于首次使用GLP-1RA（初治GLP-1R）的患者，司美格鲁肽对体重、HbA1c和血脂谱的影响显著，而在从其他GLP-1RA转换为司美格鲁肽治疗的患者中也观察到了HbA1c的改善。在为期12个月的司美格鲁肽治疗期间，肝脏脂肪变性指数（HSI）有下降趋势。此外，在初治GLP-1RA患者中观察到天冬氨酸转氨酶与血小板比值指数（APRI）显著下降。我们的真实世界研究证实了每周一次司美格鲁肽的有益作用，即改善体重、血糖控制和致动脉粥样硬化血脂谱。还提示了其对MASLD的有益作用。
