Improved glycaemia correlates with liver fat reduction in obese, type 2 diabetes, patients given glucagon-like peptide-1 (GLP-1) receptor agonists.
Improved glycaemia correlates with liver fat reduction in obese, type 2 diabetes, patients given glucagon-like peptide-1 (GLP-1) receptor agonists.
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DOI：
10.1371/journal.pone.0050117
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Kemp GJ
中科院分区：
文献类型：
--
作者：
Cuthbertson DJ;Irwin A;Gardner CJ;Daousi C;Purewal T;Furlong N;Goenka N;Thomas EL;Adams VL;Pushpakom SP;Pirmohamed M;Kemp GJ
胰高血糖素样肽-1受体激动剂（GLP-1 RA）对2型糖尿病（T2DM）肥胖患者有效，因为它们同时靶向肥胖和血脂异常。考虑到T2DM患者中非酒精性脂肪性肝病（NAFLD）的高患病率，我们确定了6个月GLP-1 RA治疗对肥胖T2DM伴肝脂肪变性患者肝内脂质（IHL）的影响，并评价了IHL变化与糖化血红蛋白（HbA1c）、体重、和腹部内脏和皮下脂肪组织的体积（VAT和SAT）。我们前瞻性研究了25例（12例男性）患者，年龄50 ± 10岁，BMI 38.4 ± 5.6 kg/m2（平均值± SD），基线IHL为28.2%（16.5 - 43.1%），HbA1c为9.6%（7.9 - 10.7%）（中位数和四分位数间距）。接受二甲双胍和磺脲类/DPP-IV抑制剂治疗的患者接受6个月GLP-1 RA（艾塞那肽，n = 19;利拉鲁肽，n = 6）。 IHL通过肝脏质子磁共振波谱（1H MRS）定量，VAT和SAT通过全身磁共振成像（MRI）定量。治疗与平均体重减轻5.0 kg（95% CI 3.5，6.5 kg）、平均HbA1c降低1.6%（17 mmol/mol）（0.8，2.4%）和IHL相对降低42%（− 59.3，− 16.5%）相关。IHL的相对降低与HbA1c相关（ρ = 0.49; p = 0.01），但与总体重、VAT或SAT无显著相关性。 治疗前水平最高的个体的国际人道主义法减少幅度最大。需要进行机制研究以确定GLP-1 RA对人肝脏脂质代谢的潜在直接影响。
Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are effective for obese patients with type 2 diabetes mellitus (T2DM) because they concomitantly target obesity and dysglycaemia. Considering the high prevalence of non-alcoholic fatty liver disease (NAFLD) in patients with T2DM, we determined the impact of 6 months’ GLP-1 RA therapy on intrahepatic lipid (IHL) in obese, T2DM patients with hepatic steatosis, and evaluated the inter-relationship between changes in IHL with those in glycosylated haemoglobin (HbA1c), body weight, and volume of abdominal visceral and subcutaneous adipose tissue (VAT and SAT). We prospectively studied 25 (12 male) patients, age 50±10 years, BMI 38.4±5.6 kg/m2 (mean ± SD) with baseline IHL of 28.2% (16.5 to 43.1%) and HbA1c of 9.6% (7.9 to 10.7%) (median and interquartile range). Patients treated with metformin and sulphonylureas/DPP-IV inhibitors were given 6 months GLP-1 RA (exenatide, n = 19; liraglutide, n = 6). IHL was quantified by liver proton magnetic resonance spectroscopy (1H MRS) and VAT and SAT by whole body magnetic resonance imaging (MRI). Treatment was associated with mean weight loss of 5.0 kg (95% CI 3.5,6.5 kg), mean HbA1c reduction of 1·6% (17 mmol/mol) (0·8,2·4%) and a 42% relative reduction in IHL (−59.3, −16.5%). The relative reduction in IHL correlated with that in HbA1c (ρ = 0.49; p = 0.01) but was not significantly correlated with that in total body weight, VAT or SAT. The greatest IHL reduction occurred in individuals with highest pre-treatment levels. Mechanistic studies are needed to determine potential direct effects of GLP-1 RA on human liver lipid metabolism.
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人类脂肪肝病：旧问题和新见解。
DOI：
10.1126/science.1204265
发表时间：
2011-06-24
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Cohen JC;Horton JD;Hobbs HH
通讯作者：
Hobbs HH
影响因子：
6.7
作者：
Svegliati-Baroni, Gianluca;Saccomanno, Stefania;Gastaldelli, Amalia
通讯作者：
Gastaldelli, Amalia
影响因子：
8.2
作者：
Lim, E. L.;Hollingsworth, K. G.;Aribisala, B. S.;Chen, M. J.;Mathers, J. C.;Taylor, R.
通讯作者：
Taylor, R.
影响因子：
24.5
作者：
Harrison, Stephen A.;Day, Christopher Paul
通讯作者：
Day, Christopher Paul
影响因子：
5.8
作者：
Bajaj, M;Suraamornkul, S;Defronzo, RA
通讯作者：
Defronzo, RA