Analysis of the clinical effect size after glucagon-like peptide-1 receptor agonist therapy on the functional activity of the intestinal microbiota, morpho-metabolic indicators and the level of psychological distress in type 2 diabetic patients

June 18, 2024
296
УДК:  616.379-008.64:616.092.19:616.008.1-08:616-094
Resume

Purpose: to determine the size of the clinical effect of glucagon-like peptide-1 receptor agonist (GLP-1ra) treatment on hormonal-metabolic, psychoemotional indicators and levels of bacterial metabolites in patients with type 2 diabetes.

Object and research methods. 88 patients with type 2 diabetes (38 men and 50 women), average age 58.37±3.35 (M±SD), who were prescribed a GLP-1ra, were examined. Before the beginning and after 6 months of therapy, indicators of anthropometry, body composition (bioimpedance method), indicators of carbohydrate metabolism, lipid spectrum of blood serum were determined; the levels of short-chain fatty acids in coprofiltrate were measured by gas chromatography and trimethylamine-N-oxide in blood serum (by immunoenzymatic method). Psychoemotional characteristics were assessed using a questionnaire.

The results. Calculations of the clinical effect (according to Hedges, Cohen) demonstrated the most pronounced effect of GLP-1ra therapy (above 0.8) on indicators of waist circumference, glycemic compensation, triglyceridemia, very low density lipoprotein cholesterol, levels of GLP-1 and TMAO in the blood. Moderate effect (0.5–0.8) was observed for the indicators of body mass index, body weight, visceral fat, total cholesterol, low density lipoprotein cholesterol, and short-chain fatty acids (acetic, propionic, fatty). According to the questionnaires, a positive clinical effect of GLP-1ra therapy was recorded on the diabetes distress assessment scale (total distress and emotional burden).

Conclusion. Calculations of the clinical effect based on the dynamics of changes in the studied clinical indicators in comparison with the initial levels prove that GLP-1ra therapy contributed to the improvement of morpho-metabolic parameters and indicators of psychoemotional status in patients with type 2 diabetes.

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