GLP-1 受体激动剂治疗可改善空腹和餐后血脂谱,与糖尿病和体重减轻无关。

Diabetes Pub Date : 2024-10-01 DOI:10.2337/db23-0972
Giuseppe Della Pepa, Bárbara G Patrício, Fabrizia Carli, Silvia Sabatini, Brenno Astiarraga, Ele Ferrannini, Stefania Camastra, Amalia Gastaldelli
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引用次数: 0

摘要

使用胰高血糖素样肽-1 受体激动剂(GLP-1RAs)治疗可减少肝脏脂肪变性和心脏代谢风险(CMR)。关于脂质代谢的数据很少,也没有关于餐后脂质组学特征的信息。因此,我们研究了艾塞那肽治疗如何改变无糖尿病的重度肥胖成人在空腹和餐后耐受试验(MTT)期间的脂质代谢和组成。30名患者(26F/4M,30-60岁,BMI>40 kg/m2,HbA1c=5.76%)被分配(1:1)接受艾塞那肽治疗(EXE,n=15,10 μg,每日两次)或不接受治疗作为对照(CT,n=15),为期3个月。对治疗前后的空腹和餐后脂质体概况(通过 LC/MS-QTOF)、脂肪酸代谢(通过 6 小时 MTT/示踪剂研究)和组成(通过 GC/MS)进行了评估。两组患者的体重都略有下降(EXE:-5.5% vs CT:-1.9%,P=0.052)。在禁食期间,与 CT 相比,艾塞那肽减少了一些以前与 CMR 相关的神经酰胺(CER)和溶血磷脂酰胆碱(LPC),同时相对增加了对 CMR 有保护作用的不饱和磷脂种类(PC、LPC),尽管总脂质种类的浓度没有变化。在 MTT 期间,两组对脂肪分解的抑制与基线相同,但 EXE 艾塞那肽显著降低了游离脂肪酸清除率和餐后三重甘油(TAG)浓度,尤其是含 44-54 个碳原子的饱和 TAG。艾塞那肽还降低了一些以前与心脏代谢风险有关的餐后 CER、PC 和 LPC。在对体重减轻进行调整后,血脂组学特征的这些变化在统计学上仍具有显著意义。艾塞那肽主要通过减少饱和的餐后 TAGs 和 CERs 来改善与 CMR 相关的空腹和餐后脂质组谱,与体重减轻和糖尿病无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
GLP-1 Receptor Agonist Treatment Improves Fasting and Postprandial Lipidomic Profiles Independently of Diabetes and Weight Loss.

Treatment with glucagon-like peptide 1 receptor agonists reduces liver steatosis and cardiometabolic risk (CMR). Few data are available on lipid metabolism, and no information is available on the postprandial lipidomic profile. Thus, we investigated how exenatide treatment changes lipid metabolism and composition during fasting and after a mixed-meal tolerance test (MMTT) in adults with severe obesity without diabetes. Thirty individuals (26 females and 4 males, 30-60 years old, BMI >40 kg/m2, HbA1c 5.76%) were assigned (1:1) to diet with exenatide 10 μg twice daily treatment (n = 15) or without treatment as control (n = 15) for 3 months. Fasting and postprandial lipidomic profile (by liquid chromatography quadrupole time-of-flight mass spectrometry) and fatty acid metabolism (following a 6-h MMTT/tracer study) and composition (by gas chromatography-mass spectrometry) were evaluated before and after treatment. Both groups had slight weight loss (-5.5% vs. -1.9%, exenatide vs. control; P = 0.052). During fasting, exenatide, compared with control, reduced some ceramides (CERs) and lysophosphatidylcholines (LPCs) previously associated with CMR, while relatively increasing unsaturated phospholipid species (phosphatidylcholine [PC], LPC) with protective effects on CMR, although concentrations of total lipid species were unchanged. During MMTT, both groups showed suppressed lipolysis equal to baseline, but exenatide significantly lowered free fatty acid clearance and postprandial triacyclglycerol (TAG) concentrations, particularly saturated TAGs with 44-54 carbons. Exenatide also reduced some postprandial CERs, PCs, and LPCs previously linked to CMR. These changes in lipidomic profile remained statistically significant after adjusting for weight loss. Exenatide improved fasting and postprandial lipidomic profiles associated with CMR mainly by reducing saturated postprandial TAGs and CERs independently of weight loss and diabetes.

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