一项初步纵向研究发现,脂肪连接蛋白可能在 GLP-1RAs 治疗 2 型糖尿病患者的代谢效应中发挥关键作用。

IF 3.7 3区 医学 Q2 Medicine Endocrine Pub Date : 2024-11-09 DOI:10.1007/s12020-024-04085-8
Antonella Al Refaie, Leonardo Baldassini, Caterina Mondillo, Elena Ceccarelli, Roberto Tarquini, Luigi Gennari, Stefano Gonnelli, Carla Caffarelli
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引用次数: 0

摘要

目的:2 型糖尿病(T2DM)是全球最普遍的代谢性疾病。T2DM 会引发多种心血管并发症,在全球范围内大大增加了发病率、死亡率和公共开支。糖尿病新药面临的真正挑战不仅在于降低血糖水平和糖化血红蛋白,还在于预防心血管风险。新出现的胰高血糖素样肽-1(GLP-1RA)受体激动剂在糖尿病管理和降低心血管风险方面发挥了关键作用:我们对 65 名白种人 T2DM 患者进行了为期 12 个月的纵向调查,评估 GLP-1RA 对心血管代谢的影响。54名T2DM患者成功完成了为期12个月的研究,其中30人接受了度拉鲁肽治疗,24人接受了赛马鲁肽治疗:在我们的研究人群中,GLP-1RA 除了能减轻体重外,还能带来一些积极的变化:脂肪分布发生了变化,表现为内脏脂肪比例降低(1.21 vs. 1.17,p 结论:GLP-1RA 能使内脏脂肪比例降低,从而减少了内脏脂肪:对 T2DM 患者来说,使用 GLP-1RAs 进行为期一年的治疗对心血管风险的主要决定因素(包括体重、内脏脂肪、血脂异常和动脉粥样硬化)有积极影响。此外,脂肪连通素的增加可能在控制炎症状态和血管损伤机制方面发挥关键作用。
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Adiponectin may play a crucial role in the metabolic effects of GLP-1RAs treatment in patients with Type 2 Diabetes Mellitus: a preliminary longitudinal study.

Purpose: Type 2 diabetes mellitus (T2DM) stands as the most prevalent metabolic disorder globally. T2DM entails numerous cardiovascular complications, which contribute significantly to morbidity, mortality, and increased public spending worldwide. The real challenge for new diabetes drugs lies not only in reducing blood glucose levels and glycated hemoglobin but also in preventing cardiovascular risk. Emerging receptor agonists for glucagon-like peptide-1 (GLP-1RAs) have demonstrated a pivotal role in diabetes management and mitigating cardiovascular risk.

Methods: We conducted a 12-month longitudinal investigation evaluating the cardio-metabolic effects of GLP-1RAs on a cohort of 65 Caucasian patients diagnosed with T2DM who were scheduled for treatment with GLP-1RAs. Fifty-four T2DM patients successfully completed the 12-month study period, with 30 receiving dulaglutide and 24 receiving semaglutide.

Results: In our study population, GLP-1RAs resulted in several positive changes beyond the observed weight loss: a shift in fat distribution, indicated by a reduction in the percentage of visceral fat (1.21 vs. 1.17, p < 0.05); a significant decrease in LDL cholesterol levels (p < 0.05) and triglycerides (p < 0.01); and a significant increase in serum adiponectin levels (p < 0.05), potentially indicating a reduction in insulin resistance and inflammation. Additionally, we observed a significant decrease in microalbuminuria and media-intimal thickness at the carotid vessel level (p < 0.05).

Conclusions: In patients with T2DM 1-year therapy with GLP-1RAs has a positive effect on the main determinants of cardiovascular risk including body weight, visceral fat, dyslipidemia, and atherosclerosis. Moreover, the increase in adiponectin may play a pivotal role in controlling the inflammatory state and the mechanisms of vascular damage.

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来源期刊
Endocrine
Endocrine 医学-内分泌学与代谢
CiteScore
6.40
自引率
5.40%
发文量
0
期刊介绍: Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.
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