Влияние глюкагоноподобного пептида-1 на эпикардиальный жир у пациентов с сахарным диабетом 2 типа и ожирением

Abstract

Aim. To evaluate the effect of a hypoglycemic drug from the group of glucagon-like peptide-1 agonists on epicardial fat thickness in patients with type 2 diabetes mellitus and obesity. Design. Open pilot study. Materials and methods. The study included 30 patients (12 women and 18 men) with type 2 diabetes mellitus and obesity of varying severity. 2 patients had a history of myocardial infarction, 20 patients had arterial hypertension of varying severity. To current therapy with oral hypoglycemic agents Dulaglutide was added with drugs for intensification at a dose of 1.5 mg once a week. At baseline and one year later, along with routine laboratory parameters, we assessed the level of glycated hemoglobin, C-reactive protein, anthropometric indicators (body weight, body mass index, waist circumference), echocardiography with determination of epicardial fat thickness, and bioimpedance measurements. Results. After 12 months of therapy, patients showed a significant decrease in the level of glycated hemoglobin by 0.95% (0.63–1.29%; p < 0.05). Improved performance of carbohydrate metabolism was accompanied by a statistically significant decrease in body weight by 0.96% (0.83–1.1%; p < 0.005), epicardial fat thickness by 0.89 cm (0.08–1.00 cm; p < 0.001) and the amount of adipose tissue according to bioimpedance measurements by 0.88 kg (0.29–0.98 kg; p < 0.05). Conclusion. Intensification therapy with the GLP-1 receptor agonist dulaglutide led to a significant improvement in carbohydrate metabolism and a decrease in the amount of fat, both total and epicardial, which could potentially reduce the risk of developing cardiovascular events in patients with type 2 diabetes and obesity. Keywords: epicardial fat, obesity, diabetes mellitus type 2, glucagon-like peptide-1 agonists.