Forskning
Udskriv Udskriv
Switch language
Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Glucose-lowering effects and mechanisms of the bile acid-sequestering resin sevelamer

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Semaglutide, reduction in HbA1c and the risk of diabetic retinopathy

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. The effect of liraglutide on renal function: A randomized clinical trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Physiological Predictors of Weight Regain at 1-Year Follow-Up in Weight-Reduced Adults with Obesity

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Postprandial Nutrient Handling and Gastrointestinal Hormone Secretion After Roux-en-Y Gastric Bypass vs Sleeve Gastrectomy

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Effects of active commuting and leisure-time exercise on appetite in individuals with overweight and obesity

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. PYY(3-36) and exendin-4 reduce food intake and activate neuronal circuits in a synergistic manner in mice

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Andreas Brønden
  • Kristian Mikkelsen
  • David P Sonne
  • Morten Hansen
  • Christoffer Våben
  • Maria N Gabe
  • Mette Rosenkilde
  • Valentina Tremaroli
  • Hao Wu
  • Fredrik Bäckhed
  • Jens F Rehfeld
  • Jens J Holst
  • Tina Vilsbøll
  • Filip K Knop
Vis graf over relationer

AIMS: Sevelamer, a non-absorbable amine-based resin used for treatment of hyperphosphatemia, has been demonstrated to hold a marked bile acid-binding potential alongside beneficial effects on lipid and glucose metabolism. The aim of this study was to investigate the glucose-lowering effect and mechanism(s) of sevelamer in patients with type 2 diabetes.

MATERIALS AND METHODS: In this double-blinded randomized controlled trial, we randomized 30 patients with type 2 diabetes to sevelamer (n=20) or placebo (n=10). Participants were subjected to standardized 4-hour liquid meal tests at baseline and following seven days of treatment. The main outcome measure was plasma glucagon-like peptide-1 excursions as measured by area under the curve. In addition, blood was sampled for measurements of glucose, lipids, glucose-dependent insulinotropic polypeptide, C-peptide, glucagon, fibroblast growth factor-19, cholecystokinin and bile acids. Assessments of gastric emptying, resting energy expenditure and gut microbiota composition were performed.

RESULTS: Sevelamer elicited a significant placebo-corrected reduction in plasma glucose with concomitant reduced fibroblast growth factor-19 concentrations, increased de novo synthesis of bile acids, a shift towards a more hydrophilic bile acid pool and increased lipogenesis. No glucagon-like peptide-1-mediated effects on insulin, glucagon or gastric emptying were evident, which point to limited contribution of this incretin hormone to the glucose-lowering effect of sevelamer. Furthermore, no sevelamer-mediated effects on gut microbiota composition or resting energy expenditure were observed.

CONCLUSIONS: Sevelamer reduced plasma glucose concentrations in patients with type 2 diabetes by mechanisms that seemed to involve decreased intestinal and hepatic bile acid-mediated farnesoid X receptor activation.

OriginalsprogEngelsk
TidsskriftDiabetes, Obesity and Metabolism
Vol/bind20
Udgave nummer7
Sider (fra-til)1623-1631
Antal sider8
ISSN1462-8902
DOI
StatusUdgivet - jul. 2018

ID: 52823097