摘要
目的 观察胰高血糖素样肽1受体激动剂(GLP-1RA)司美格鲁肽治疗对超重/肥胖2型糖尿病患者腹部脂肪分布和颈部棕色脂肪组织(BAT)活性的影响。方法 超重/肥胖2型糖尿病患者32例,分为观察组18例、对照组14例。观察组予以司美格鲁肽皮下注射,起始剂量为0.25 mg、每周1次,逐步调整达到1.0 mg、每周1次;对照组予以不含GLP-1RA和二肽基肽酶4抑制剂类药物的降糖方案。两组均治疗3个月。分别于治疗前后测量两组的身高、体重、腰围和BMI;检测空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C);评估胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(HOMA-IS)和胰岛β细胞功能(HOMA-β);进行MRI检查,测量腹部皮下脂肪组织(SAT)、内脏脂肪组织(VAT)面积及颈部BAT活性(以C3~4、C4~5、C5~6椎间隙T2*值表示)。结果 与治疗前相比,观察组治疗后体重、腰围、BMI、FPG及SAT、VAT面积下降,HOMA-β及C3~4、C4~5、C5~6椎间隙T2*值增高(P均<0.05);观察组治疗后体重、腰围、BMI、HOMA-IR低于对照组,HOMA-IS、HOMA-β高于对照组(P均<0.05)。结论 司美格鲁肽治疗超重/肥胖2型糖尿病有显著的减重、降糖和改善胰岛β细胞功能的效果,并有助于降低腹部皮下脂肪和内脏脂肪含量,增强颈部BAT活性;司美格鲁肽可能通过减少腹部脂肪分布、提高BAT活性来发挥减重和改善代谢的作用。
Objective To observe the effects of semaglutide,a glucagon-like peptide-1 receptor agonist(GLP1RA),on abdominal fat distribution and brown adipose tissue(BAT)activity in the neck region of overweight/obese patients with type 2 diabetes mellitus(T2DM).Methods Thirty-two overweight/obese patients with T2DM were divided into the observation group(n=18)and control group(n=14).The observation group received subcutaneous injections of semaglutide starting at 0.25 mg weekly,gradually titrated to 1.0 mg weekly.The control group was maintained on a hypoglycemic regimen excluding GLP-1 receptor agonists(GLP-1RAs)and dipeptidyl peptidase-4(DPP-4)inhibitors.Both groups underwent a 3-month intervention period.Anthropometric parameters,including height,weight,waist circumference,and body mass index(BMI),were measured before and after treatment.We detected the fasting plasma glucose(FPG),fasting insulin(FINS),glycated hemoglobin(HbA1c),triglycerides(TG),and low-density lipoprotein cholesterol(LDL-C).Insulin resistance index(HOMA-IR),insulin sensitivity index(HOMA-IS),and pancreaticβ-cell function(HOMA-β)were assessed.Abdominal subcutaneous adipose tissue(SAT)area,visceral adipose tissue(VAT)area,and neck brown adipose tissue(BAT)activity were quantified by magnetic resonance imaging(MRI),with BAT activity represented by T2 values at the C3-4,C4-5,C5-6 vertebral levels.Results Compared with pre-treatment levels,the body weight,waist circumference,BMI,FPG,and both SAT and VAT areas following treatment decreased,while HOMA-βand T2*values at C3-4,C4-5,C5-6 intervertebral spaces increased in the observation group(all P<0.05).After treatment,the observation group exhibited lower body weight,waist circumference,BMI,and HOMA-IR than the control group,while HOMA-IS and HOMA-βwere higher than those of the control group(all P<0.05).Conclusions In overweight/obese patients with type 2 diabetes,semaglutide treatment produces significant reductions in body weight and blood glucose along with improved pancreaticβ-cell function.It also lowers abdominal visceral and subcutaneous fat content and elevates neck BAT activity.Semaglutide may exert its weight-loss and metabolic-improvement effects by decreasing abdominal fat distribution and enhancing BAT activity.
作者
符瑶
徐亚萍
尹晓
王建
FU Yao;XU Yaping;YIN Xiao;WANG Jian(School of Clinical Medicine,Shandong Second Medical University,Weifang 261053,China;不详)
出处
《山东医药》
2025年第12期51-56,共6页
Shandong Medical Journal
基金
山东省自然科学基金面上项目(ZR2021MH204)。
关键词
司美格鲁肽
肥胖症
2型糖尿病
皮下脂肪组织
内脏脂肪组织
棕色脂肪组织活性
核磁共振成像
semaglutide
obesity
type 2 diabetes mellitus
subcutaneous fat tissues
visceral fat tissues
brown adipose tissue activity
magnetic resonance imaging
