Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 2 de 2
Filter
Add more filters










Database
Language
Publication year range
1.
Nutrients ; 10(12)2018 Dec 02.
Article in English | MEDLINE | ID: mdl-30513818

ABSTRACT

Thromboxane (TX)-dependent platelet activation and lipid peroxidation, as reflected in vivo by the urinary excretion of 11-dehydro-TXB2 and 8-iso-prostaglandin (PG)F2α, play a key role in atherothrombosis in obesity and type 2 diabetes mellitus (T2DM) since the earlier stages. Thirty-five metformin-treated obese subjects with prediabetes or newly-diagnosed T2DM were randomized to the glucagon-like peptide receptor agonist (GLP-RA) liraglutide (1.8 mg/day) or lifestyle counseling until achieving a comparable weight loss (-7% of initial body weight), to assess whether changes in subcutaneous (SAT) and visceral (VAT) adipose tissue distribution (MRI), insulin sensitivity (Matsuda Index) and beta-cell performance (multiple sampling OGTT beta-index), with either intervention, might affect TX-dependent platelet activation, lipid peroxidation and inflammation. At baseline, Ln-8-iso-PGF2α (Beta = 0.31, p = 0.0088), glycosylated hemoglobin (HbA1c) (Beta = 2.64, p = 0.0011) Ln-TNF-α (Beta = 0.58, p = 0.0075) and SAT (Beta = 0.14, p = 0.044) were significant independent predictors of 11-dehydro-TXB2. After achievement of the weight loss target, a comparable reduction in U-11-dehydro-TXB2 (between-group p = 0.679) and 8-iso-PGF-2α (p = 0.985) was observed in both arms in parallel with a comparable improvement in glycemic control, insulin sensitivity, SAT, high-sensitivity C-reactive protein (hs-CRP). In obese patients with initial impairment of glucose metabolism, the extent of platelet activation is related to systemic inflammation, isoprostane formation and degree of glycemic control and abdominal SAT. Successful weight loss, achieved with either lifestyle changes or an incretin-based therapy, is associated with a significant reduction in lipid peroxidation and platelet activation.


Subject(s)
Diabetes Mellitus/therapy , Life Style , Liraglutide/therapeutic use , Obesity/therapy , Platelet Activation/physiology , Thromboxanes/physiology , Blood Glucose/analysis , Diabetes Mellitus/blood , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/therapy , Diet , Dinoprost/analogs & derivatives , Dinoprost/urine , Exercise , Female , Glycated Hemoglobin/analysis , Humans , Lipid Peroxidation , Longitudinal Studies , Male , Middle Aged , Obesity/blood , Obesity/complications , Prediabetic State/blood , Prediabetic State/therapy , Thromboxane B2/analogs & derivatives , Thromboxane B2/urine , Weight Loss
2.
Diabetes Care ; 40(11): 1556-1564, 2017 11.
Article in English | MEDLINE | ID: mdl-28912305

ABSTRACT

OBJECTIVE: Obesity is associated with an increased risk of type 2 diabetes and cardiovascular complications. The risk depends significantly on adipose tissue distribution. Liraglutide, a glucagon-like peptide 1 analog, is associated with weight loss, improved glycemic control, and reduced cardiovascular risk. We determined whether an equal degree of weight loss by liraglutide or lifestyle changes has a different impact on subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in obese subjects with prediabetes or early type 2 diabetes. RESEARCH DESIGN AND METHODS: Sixty-two metformin-treated obese subjects with prediabetes or newly diagnosed type 2 diabetes, were randomized to liraglutide (1.8 mg/day) or lifestyle counseling. Changes in SAT and VAT levels (determined by abdominal MRI), insulin sensitivity (according to the Matsuda index), and ß-cell function (ß-index) were assessed during a multiple-sampling oral glucose tolerance test; and circulating levels of IGF-I and IGF-II were assessed before and after a comparable weight loss (7% of initial body weight). RESULTS: After comparable weight loss, achieved by 20 patients per arm, and superimposable glycemic control, as reflected by HbA1c level (P = 0.60), reduction in VAT was significantly higher in the liraglutide arm than in the lifestyle arm (P = 0.028), in parallel with a greater improvement in ß-index (P = 0.021). No differences were observed in SAT reduction (P = 0.64). IGF-II serum levels were significantly increased (P = 0.024) only with liraglutide administration, and the increase in IGF-II levels correlated with both a decrease in VAT (ρ = -0.435, P = 0.056) and an increase in the ß-index (ρ = 0.55, P = 0.012). CONCLUSIONS: Liraglutide effects on visceral obesity and ß-cell function might provide a rationale for using this molecule in obese subjects in an early phase of glucose metabolism dysregulation natural history.


Subject(s)
Diabetes Mellitus, Type 2/drug therapy , Insulin-Secreting Cells/drug effects , Liraglutide/therapeutic use , Obesity/drug therapy , Prediabetic State/drug therapy , Weight Loss/drug effects , Adipocytes/drug effects , Blood Glucose/metabolism , Body Mass Index , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/complications , Female , Glucagon-Like Peptide 1/analogs & derivatives , Glucagon-Like Peptide 1/therapeutic use , Glucose Tolerance Test , Glycated Hemoglobin/metabolism , Humans , Hypoglycemic Agents/therapeutic use , Insulin-Like Growth Factor I/metabolism , Insulin-Like Growth Factor II/metabolism , Insulin-Secreting Cells/metabolism , Life Style , Longitudinal Studies , Lost to Follow-Up , Male , Metformin/therapeutic use , Middle Aged , Obesity/blood , Obesity/complications , Prediabetic State/blood , Risk Factors
SELECTION OF CITATIONS
SEARCH DETAIL
...