Diabetes care:利拉鲁肽只在短期治疗后降低CNS对食物的响应

2015-08-21 zhaozhou 译 MedSci原创

 肥胖和糖尿病由于其高发对人类健康造成了巨大的负担。肥胖是长期的额外能量摄取的结果。中枢神经系统(CNS)对于食物的摄取和维持体重有着重要的作用。研究已经表明,CNS满足和奖励机制可能会增加食物的摄取。使用功能性核磁共振成像技术(fMRI)可以发现肥胖病人CNS对食物的图片做出反应,CNS激活发生改变。为了寻找治疗肥胖的方案,研究人员进行了许多尝试,只有GLP-1(胰高血糖素样多肽1)这

肥胖和糖尿病由于其高发对人类健康造成了巨大的负担。肥胖是长期的额外能量摄取的结果。中枢神经系统(CNS)对于食物的摄取和维持体重有着重要的作用。


研究已经表明,CNS满足和奖励机制可能会增加食物的摄取。使用功能性核磁共振成像技术(fMRI)可以发现肥胖病人CNS对食物的图片做出反应,CNS激活发生改变。为了寻找治疗肥胖的方案,研究人员进行了许多尝试,只有GLP-1(胰高血糖素样多肽1)这种激素取得了成效。GLP-1是一种胃激素,是在食物从肠内分泌L细胞中消化后分泌的。GLP-1有降糖作用。

在过去十年中,基于GLP-1的治疗方案已经成功用于糖尿病的治疗。有趣的是,GLP-1受体激动剂(GLP-1RA)还可以抑制食物摄取。利拉鲁肽是一种GLP-1受体激动剂,可以降低食欲,减轻体重。研究人员探索了这些效果是否是通过CNS介导发生的。研究人员进行了一项随机交叉试验。20名平均年龄为59.3岁的2型糖尿病患者参与了此次研究。试验包括了两阶段的12周治疗,治疗药物为利拉鲁肽1.8mg或者甘精胰岛素。使用fMRI来确定禁食和餐后30min患者CNS对食物图片的响应。结果表明,使用利拉鲁肽的患者体重出现了下降。十天后,利拉鲁肽组的患者对食物图片的响应出现下降。

相较于胰岛素,利拉鲁肽仅在短期治疗后显著降低CNS活性。这暗示GLP-1RA的这些作用可以是诱导体重降低的原因,鉴于更长期的治疗后,利拉鲁肽对CNS的影响消失,这说明GLP-1RA未必是维持体重的原因。

原始出处:

Jennifer S. ten Kulve et al. Liraglutide Reduces CNS Activation in Response to Visual Food Cues Only After Short-term Treatment in Patients With Type 2 Diabetes.Published online before print August 17, 2015, doi:10.2337/dc15-0772

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    2015-10-08 lg.zhao
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    2015-08-23 yhy100201
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    2015-08-21 shuaijing1986

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