背景:戒烟对于减少2型糖尿病(T2DM)的并发症至关重要,但是相关的体重增加会恶化血糖控制,令人沮丧的戒烟尝试。伐尼克林,α4β2烟碱受体的部分激动剂,有助于戒烟。这项研究检查了伐尼克林对T2DM和糖尿病前期患者体重和代谢参数的影响。
方法:纳入53例患者,其中32人在伐尼克兰三个月疗程后成功戒烟,并在没有用药的情况下再增加一个月后进行检查。基线测量值,2.5个月,4个月包括体重,血压,静息代谢率(RMR),糖化血红蛋白(HbA1c),空腹血糖,血脂,C反应蛋白(CRP),与食欲有关的荷尔蒙,和身体活动。
结果:治疗后,体重没有显著变化,血压,RMR,或血糖控制。总胆固醇(CHOL)和低密度脂蛋白胆固醇(LDL-C)在研究的4个月时显著下降(从168到156毫克/分升,p=0.013,从96到83毫克/分升,分别为p=0.013)。瘦素水平增加(从11到13.8ng/dL,p=0.004),胰高血糖素样肽-1(GLP-1)水平(从39.6到45.8pM,p=0.016),随访4个月。报告中等强度活动的参与者百分比从28%增加到56%,而那些报告高强度活动的人从19%增加到22%,分别(p=0.039)。
结论:我们的研究表明,在患有T2DM和糖尿病前期的吸烟者中,使用伐尼克兰戒烟可显著改善血脂状况。血浆瘦素和GLP-1水平显着增加,增加体力活动,没有明显的体重增加。因此,对于这些吸烟者来说,戒烟而不增加体重或血糖控制恶化是可行的。增加脂质分布的好处,GLP-1法规,和身体活动。
BACKGROUND: Smoking cessation is crucial for reducing complications of type 2 diabetes mellitus (T2DM), but associated weight gain can worsen glycemic control, discouraging quitting attempts. Varenicline, a partial agonist of α4β2 nicotinic receptors, aids smoking cessation. This study examines the effects of varenicline on body weight and metabolic parameters in patients with T2DM and prediabetes.
METHODS: Fifty-three patients were enrolled, of which 32 successfully quit smoking after a three-month course of varenicline and were examined after an additional month with no medication. Measurements taken at baseline, 2.5 months, and 4 months included body weight, blood pressure, resting metabolic rate (RMR), glycated hemoglobin (HbA1c), fasting glucose, blood lipids, C-reactive protein (CRP), appetite-related hormones, and physical activity.
RESULTS: Post-treatment, there were no significant changes in body weight, blood pressure, RMR, or glycemic control. Total (CHOL) and low-density lipoprotein (LDL-C) cholesterol decreased significantly at 4 months of the study (from 168 to 156 mg/dL, p = 0.013, and from 96 to 83 mg/dL, p = 0.013, respectively). Leptin levels increased (from 11 to 13.8 ng/dL, p = 0.004), as did glucagon-like peptide-1 (GLP-1) levels (from 39.6 to 45.8 pM, p = 0.016) at 4 months of follow-up. The percentage of participants who reported moderate-intensity activity increased from 28% to 56%, while those reporting high-intensity activity increased from 19% to 22%, respectively (p = 0.039).
CONCLUSIONS: Our study showed that smoking cessation with varenicline in smokers with T2DM and prediabetes led to significant improvements in lipid profile, significant increase in plasma leptin and GLP-1 levels, and increased physical activity, without significant weight gain. Thus, smoking cessation without weight gain or deteriorated glycemic control is feasible for these smokers, with added benefits to lipid profiles, GLP-1 regulation, and physical activity.