Body Fat Depletion: the Yin Paradigm for Treating Type 2 Diabetes.

IF 5.7 2区医学 Q1 PERIPHERAL VASCULAR DISEASE Current Atherosclerosis Reports Pub Date : 2024-01-01 Epub Date: 2023-12-27 DOI:10.1007/s11883-023-01181-4

Jingjing Zhu, John P H Wilding

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Abstract

Purpose of review: To highlight that body fat depletion (the Yin paradigm) with glucose-lowering treatments (the Yang paradigm) are associated with metabolic benefits for patients with type 2 diabetes mellitus (T2DM).

Recent findings: The sodium-glucose cotransporter-2 inhibitor-mediated sodium/glucose deprivation can directly improve glycemic control and kidney outcome in patients with T2DM. The glucose deprivation might also promote systemic fatty acid β-oxidation to deplete ectopic/visceral fat and thereby contribute to the prevention of cardiovascular diseases. As with metabolic surgery, bioengineered incretin-based medications with potent anorexigenic and insulinotropic efficacy can significantly reduce blood glucose as well as body weight (especially in the ectopic/visceral fat depots). The latter effects could be a key contributor to their cardiovascular-renal protective effects. In addition to a healthy diet, the newer glucose-lowering medications, with body fat reduction effects, should be prioritized when treating patients with T2DM, especially for those with established cardiovascular/renal risks or diseases.

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消耗体内脂肪：治疗 2 型糖尿病的阴范例。

综述目的：强调体内脂肪消耗（阴范式）与降糖治疗（阳范式）对 2 型糖尿病（T2DM）患者的代谢有益：钠-葡萄糖共转运体-2 抑制剂介导的钠/葡萄糖剥夺可直接改善 T2DM 患者的血糖控制和肾脏预后。葡萄糖剥夺还可促进全身脂肪酸β氧化，消耗异位/内脏脂肪，从而有助于预防心血管疾病。与代谢手术一样，生物工程增量素药物具有强大的厌食和促胰岛素作用，可显著降低血糖和体重（尤其是异位/内脏脂肪）。后者的作用可能是其心血管-肾脏保护作用的关键因素。在治疗 T2DM 患者时，除了健康饮食外，还应优先考虑具有减少体脂作用的新型降糖药物，尤其是对那些已有心血管/肾脏风险或疾病的患者。

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来源期刊

Current Atherosclerosis Reports 医学-

CiteScore

9.00

自引率

3.40%

发文量

审稿时长

6-12 weeks

期刊介绍： The aim of this journal is to systematically provide expert views on current basic science and clinical advances in the field of atherosclerosis and highlight the most important developments likely to transform the field of cardiovascular prevention, diagnosis, and treatment. We accomplish this aim by appointing major authorities to serve as Section Editors who select leading experts from around the world to provide definitive reviews on key topics and papers published in the past year. We also provide supplementary reviews and commentaries from well-known figures in the field. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.

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