背景:棕色脂肪组织(BAT)由于其产热和抗肥胖特性,已成为代谢紊乱的潜在治疗靶标。β3-肾上腺素能受体(β3-AR)激动剂作为BAT激活和代谢调节的潜在药物也受到关注。Mirabegron,临床上用于膀胱过度活动症的选择性β3-AR激动剂,已被探索其在代谢紊乱中的效用。然而,围绕Mirabegron激活BAT以加速新陈代谢的能力的争议需要进一步研究。本系统综述的目的是全面描述米拉贝隆对人类BAT及其代谢的影响。
方法:我们搜索了PubMedCentral,WebofScience,Embase,和CochraneLibrary数据库,用于从数据库建立之日起至2023年3月发表的相关论文,以进行系统评价和荟萃分析。我们提取了主要结果指标的数据,如BAT量,BAT活动,体温,和静息能量消耗(REE),以及次要结果指标,如心率(HR),舒张压(DBP),收缩压(SBP),非酯化脂肪酸(NEFA),血糖,和相关研究的血液胰岛素。对于没有为荟萃分析提供合适数据的研究,我们使用了叙事数据合成。对于为荟萃分析提供合适数据的研究,我们使用RevMan5.4软件进行了荟萃分析。
结果:我们回顾了10篇论文,其中6篇纳入了我们的荟萃分析。我们的发现表明,与安慰剂或给药前人群相比,米拉贝隆的BAT体积(p=0.72)或血糖(p=0.52)没有显着变化。然而,患者BAT活性显着增加(p<0.01),血液NEFA(p<0.01),体温(p<0.01),稀土元素(p<0.01),HR(p<0.01),DBP(p<0.01),SBP(p=0.25),血胰岛素(p<0.01)。
结论:通过我们对6篇论文的荟萃分析,我们发现米拉贝隆有可能增加人类的BAT活动,REE,NEFA内容,体温,HR,血压,和血液胰岛素含量。这些作用可能导致肥胖/超重和糖尿病患者的血糖水平降低。此外,米拉贝隆激活BAT可以代表一种治疗肥胖的新方法,糖尿病,和心血管疾病。
■CRD42023413446,2023年4月11日。
BACKGROUND: Brown adipose tissue (BAT) has emerged as a potential therapeutic target for metabolic disorders due to its thermogenic and anti-obesity properties. β3-adrenergic receptor (β3-AR) agonists have also gained attention as potential agents for BAT activation and metabolic regulation. Mirabegron, a selective β3-AR-agonist used clinically for overactive bladder syndrome, has been explored for its utility in metabolic disorders. However, the controversy surrounding the ability of mirabegron to activate BAT to accelerate metabolism requires further investigation. The aim of this systematic
review is to characterize comprehensively the impact of mirabegron on human BAT and its metabolism.
METHODS: We searched PubMed Central, Web of Science, Embase, and Cochrane Library databases for relevant papers published from the date of database inception to March 2023 for systematic reviews and meta-analyses. We extracted data on primary outcome indicators such as BAT volume, BAT activity, body temperature, and resting energy expenditure (REE), as well as secondary outcome indicators such as heart rate (HR), diastolic blood pressure (DBP), systolic blood pressure (SBP), non-esterified fatty acids (NEFA), blood glucose, and blood insulin from relevant studies. For studies that did not provide suitable data for meta-analysis, we used narrative data synthesis. For studies that provided suitable data for meta-analysis, we conducted meta-analysis using RevMan 5.4 software.
RESULTS: We reviewed 10 papers and included 6 in our meta-analysis. Our findings revealed no significant changes in BAT volume (p = 0.72) or blood glucose (p = 0.52) with mirabegron when compared to the placebo or pre-dose population. However, patients showed significant increases in BAT activity (p < 0.01), blood NEFA (p < 0.01), body temperature (p < 0.01), REE (p < 0.01), HR (p < 0.01), DBP (p < 0.01), SBP (p = 0.25), and blood insulin (p < 0.01).
CONCLUSIONS: Through our meta-analysis of 6 papers, we found that mirabegron has the potential to increase human BAT activity, REE, NEFA content, body temperature, HR, blood pressure, and blood insulin content. These effects may lead to reductions in blood glucose levels in obese/overweight and diabetic patients. Additionally, the activation of BAT by mirabegron could represent a novel approach for treating obesity, diabetes, and cardiovascular disease.
UNASSIGNED: CRD42023413446, 04/11/2023.