PDF(Pubmed)
Abstract：
Once-weekly semaglutide is a widely used glucagon-like peptide-1 receptor agonist (GLP-1RA) used for the treatment of type 2 diabetes (T2D). In clinical trials, semaglutide improved glycemic control and obesity, and reduced major cardiovascular events. However, the reports are limited on its real-world efficacy relating to various metabolic factors such as dyslipidemia or metabolic dysfunction-associated steatotic liver disease (MASLD) in Asian patients with T2D. In our retrospective longitudinal study, we selected patients with T2D who were given once-weekly semaglutide and compared metabolic parameters before and after the start of semaglutide. Seventy-five patients were eligible. HbA1c decreased significantly, by 0.7-0.9%, and body weight by 1.4-1.7 kg during the semaglutide treatment. Non-HDL cholesterol decreased significantly at 3, 6 and 12 months after the initiation of semaglutide; LDL cholesterol decreased at 3 and 6 months; and HDL cholesterol increased at 12 months. The effects on body weight, HbA1c and lipid profile were pronounced in patients who were given semaglutide as a first GLP-1RA (GLP-1R naïve), whereas improvements in HbA1c were also observed in patients who were given semaglutide after being switched from other GLP-1RAs. During a 12-month semaglutide treatment, the hepatic steatosis index (HSI) tended to decrease. Moreover, a significant decrease in the AST-to-platelet ratio index (APRI) was observed in GLP-1RA naïve patients. Our real-world study confirmed the beneficial effects of once-weekly semaglutide, namely, improved body weight, glycemic control and atherogenic lipid profile. The beneficial effects on MASLD were also suggested.
摘要：
每周一次的司马鲁肽是一种广泛使用的胰高血糖素样肽-1受体激动剂（GLP-1RA），用于治疗2型糖尿病（T2D）。在临床试验中,司马鲁肽改善血糖控制和肥胖，减少主要心血管事件。然而,在亚洲T2D患者中,其与血脂异常或代谢功能障碍相关的脂肪变性肝病(MASLD)等各种代谢因素相关的真实世界疗效报道有限.在我们的回顾性纵向研究中，我们选择了每周一次服用司美鲁肽的T2D患者,并比较了司美鲁肽开始前后的代谢参数.75名患者符合资格。HbA1c显著下降,0.7-0.9%，在司马鲁肽治疗期间，体重减少1.4-1.7公斤。semaglutide开始后3、6和12个月，非HDL胆固醇显着降低；LDL胆固醇在3和6个月时降低；HDL胆固醇在12个月时升高。对体重的影响，HbA1c和血脂分布在服用司马鲁肽作为第一个GLP-1RA（GLP-1R未治疗）的患者中明显，而在从其他GLP-1RA转换后给予司美鲁肽的患者中也观察到HbA1c改善。在12个月的司马鲁肽治疗中，肝脏脂肪变性指数（HSI）呈下降趋势。此外，在GLP-1RA初治患者中,AST-血小板比值指数(APRI)显著下降.我们的真实世界研究证实了每周一次司马鲁肽的有益效果，即,改善体重，血糖控制和动脉粥样硬化脂质分布。还提出了对MASLD的有益效果。
