Endocrine Abstracts

Background: Type 2 diabetes (T2D) is a progressive disease. The gut microbiota has recently been identified as a new potential diabetes risk factor. Short-chain fatty acids (SCFAs) are organic fatty acids produced in the distal gut by bacterial fermentation of macrofibrous material that might improve T2D.

Aims: To examine the effectiveness of glucagon-like peptide (GLP)-1 receptor agonist treatment on SCFAs, carbohydrate and lipid metabolism in patients with T2D.

Materials and methods: Sixteen patients with T2D were enrolled in this prospective study. The mean age of patients was 45 (30–60) years. The levels of SCFAs, lipoproteins, serum fasting glucose, glycated hemoglobin (HbA1c), and body mass index (BMI) were examined at baseline and at 8 weeks on aGLP-1 therapy.

Results: At baseline the average glucose levels were 8.18 [5.3; 15.2] mmol/l, HbA1c – 6.7 [4.6; 9.8] %; total serum cholesterol (TC) – 5.46 [3.49; 7.83] mmol/l, low-density lipoprotein (LDL) – 4.26 [2.46; 6.65] mmol/l, high-density lipoprotein (HDL) – 1.17 [0.85; 1.76] mmol/l, triglycerides (TG) – 1.82 [0.56; 3.4] mmol/l and BMI – 39.35 [31.9; 51.0] kg/m². After 8 weeks of aGLP-1 treatment was detected a significant decrease in mean glucose levels by 18.2%, HbA1c by 5.22%, TC by 5.31%, LDL by 10%, TG by 12%, BMI by 3.43%, and no significant increase in HDL by 4% from baseline. SCFAs were analyzed in 7 patients. Despite the small number of patients, a significant positive relationship between acetate and BMI (r(s)=0.31; P=0.039), HbA1c (r(s)=0.28; P=0.015), LDL (r(s)=0.26; P=0.039), and negative relationship between butyrate and glucose (r(s)=−0.41, P=0.014), TG (r(s)=−0.29, P=0.04) were revealed at baseline. There was no significant correlation between propionate and above parameters. GLP-1 therapy was associated with significant decrease in acetate (from 3.48 [1.26; 7.149] to 2.61 [1.43; 3.5]) (P<0.01); no significant in propionate (from 1.29 [0.74; 1.39] to 1.06 [0.77; 1, 39] mg/g) (P>0.05) and increase in butyrate (from 0.76 [0.4; 0.98] to 0.86 [0.42; 1.4]) (P>0.05). Acetate decrease is associated with decrease in BMI for more than 3% at baseline and an improvement in glycaemia.

Conclusions: The preliminary results are indicating a positive effect of GLP-1 on weight, carbohydrate and lipid metabolism and short-chain fatty acids in patients with T2D.