Author Interviews, Diabetes, Kidney Disease, Nature, Semaglutide / 31.10.2024
Study Finds Semaglutide Reduced Kidney Inflammation and Blood Pressure in Obese Patients Without Diabetes
MedicalResearch.com Interview on publication of:
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Prof. Heerspink[/caption]
Prof. dr. H.J. (Hiddo) Lambers Heerspink
Clinical Pharmacologist
Faculty of Medical Sciences
University of Groningen
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The diabetes drug semaglutide, also known as Ozempic, has a positive effect for patients with chronic kidney damage and obesity. The amount of protein in their urine decreased, as did the degree of inflammation of their kidneys and their blood pressure.
Hiddo L. Heerspink got the idea for this study at the beginning of the corona pandemic. Earlier, he had discovered that another class of drugs against diabetes-2, the so-called SGLT2 inhibitors also appeared to work well for patients with chronic kidney damage without diabetes. He therefore wanted to investigate whether semaglutide would also work positively for patients with chronic kidney disease and obesity.
Prof. Heerspink[/caption]
Prof. dr. H.J. (Hiddo) Lambers Heerspink
Clinical Pharmacologist
Faculty of Medical Sciences
University of Groningen
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The diabetes drug semaglutide, also known as Ozempic, has a positive effect for patients with chronic kidney damage and obesity. The amount of protein in their urine decreased, as did the degree of inflammation of their kidneys and their blood pressure.
Hiddo L. Heerspink got the idea for this study at the beginning of the corona pandemic. Earlier, he had discovered that another class of drugs against diabetes-2, the so-called SGLT2 inhibitors also appeared to work well for patients with chronic kidney damage without diabetes. He therefore wanted to investigate whether semaglutide would also work positively for patients with chronic kidney disease and obesity.
Dr. Magruder[/caption]
Matthew Magruder, MD PGY3
Orthopaedic Residency Program
Department of Orthopaedic Surgery and Rehabilitation
Maimonides Medical Center
MedicalResearch.com: What is the background for this study?
Response: The prevalence of obesity and diabetes mellitus has reached epidemic proportions. Approximately 37.3 million people in the United States, accounting for 11.3% of the total population, have diabetes, and 100.1 million, or 41.9%, of all US citizens are obese. Furthermore, these numbers are only projected to increase in the coming decades. This is an issue for orthopaedic surgeons because diabetes and obesity have consistently been demonstrated to be risk factors for complications following total joint replacements, especially total hip replacements. Therefore, we are in desperate need of new and more effective tools in mitigating the risk of poor outcomes in our joint replacement patients.
Semaglutide, and other GLP-1 agonists, are potentially a new tool that can be used to help decrease the risks following joint replacement surgery. Initially a medication to treat diabetes, semaglutide has recently been approved by the FDA to treat obesity as well, as randomized controlled trials have consistently demonstrated significant weight loss with minimal side effects. The purpose of our study was to see what effect the use of semaglutide had on total hip arthroplasty patient outcomes.
Dr. Dolatshahi[/caption]
Mahsa Dolatshahi, M.D., M.P.H.
Post-doctoral research fellow
Mallinckrodt Institute of Radiology (MIR)
Washington University School of Medicine
St. Louis
MedicalResearch.com: What is the background for this study?
Response: Obesity at midlife is recognized as a risk factor for developing Alzheimer disease decades afterwards. However, body mass index on its own does not adequately represent the risks associated with obesity.
In this study, we went beyond BMI and considered anatomical distribution of body fat, including the metabolically active visceral fat in the belly, and showed its association with Alzheimer pathology in the form of amyloid proteins. In addition, visceral fat along with obesity and insulin resistance were associated with thinning of brain cortex, as early as midlife.
Dr. GALBIATI[/caption]
Francesca Galbiati, MD
Clinical/Research fellow in Endocrinology
Massachusetts General Hospital
MedicalResearch.com: What is the background for this study?
Response: Arginine-vasopressin (AVP) is a neurohormone well known for its role in water balance regulation. It promotes renal water absorption in the kidney, to maintain normal sodium levels in the blood via a tightly controlled osmotic regulation. Besides AVP classical role, data have shown that AVP effects extend beyond water balance regulation. Animal studies have shown that AVP has metabolic effects, including reducing food intake, inducing lipolysis, and promoting muscle regeneration in male mice.
Furthermore, AVP is regulated differently in males and females, and affects cognition differently across sexes, a phenomenon called sexual dimorphism. However, it is unknown whether its dimorphism translates to metabolism. Also, findings on AVP metabolic role are inconsistent, possibly due to the opposing effects of AVP at different receptor subtypes, which regulation is still largely unknown. We performed this study to better investigate AVP metabolic role, and explore sex differences. We hypothesized that AVP would be positively associated with BMI, adiposity, and lean mass (acting as a signal of energy availability). We also predicted that relationships between AVP and body composition measures would differ by sex. We used the AVP area under the curve around a standardized meal to better capture repeated measures in response to food intake (that directly impacts energy availability). This also allowed to avoid the possible risk of fluctuating AVP levels due to possible pulsatile secretion.
Yuxia Wei[/caption]
Yuxia Wei | PhD Student
Unit of Epidemiology
Institute of Environmental Medicine
Karolinska Institutet
Stockholm | Sweden
MedicalResearch.com: What is the background for this study?
Response: Diabetes is traditionally known for having two types (type 1 diabetes and type 2 diabetes). However, it is becoming increasingly clear that diabetes is much more complex than this traditional classification. Several attempts have been made to address this heterogeneity and in 2018, a Swedish ground-breaking study proposed that there are five distinct subtypes of diabetes in adults. They have been replicated in different populations and it has been shown that there are differences between the subtypes in terms of genetics and risks of complications. Another way of elucidating the relevance of these subtypes is to investigate whether the influence of known risk factors for diabetes is different on different subtypes. Our study is one of the first attempts to address this. We used a study design known as Mendelian randomization, to investigate the influence of childhood obesity on these diabetes subtypes that typically occur after age 35. This work was a collaboration between Karolinska institutet in Stockholm, University of Bristol in the UK and Sun Yat-Sen University in China.
Dr. Malin[/caption]
Steven K. Malin, PhD, FACSM (he/him)
Associate Professor
Department of Kinesiology and Health | School of Arts and Sciences
Division of Endocrinology, Metabolism and Nutrition | Robert Wood Johnson Medical School
Institute of Translational Medicine and Science
New Brunswick, NJ 08901
MedicalResearch.com: What is the background for this study?
Response: Type 2 diabetes is a condition where blood glucose (sugar) is elevated in the blood. This can be problematic as it leads to blood vessel damage and the promotion of cardiovascular disease. Nearly 30 million people in the U.S. have type 2 diabetes, making it a major public health issue. The cause is not entirely clear, but many, including our team view insulin resistance as a central culprit.
Insulin resistance is when the body does not respond well to the hormone insulin. Insulin is vital because it promotes glucose uptake into tissues, like skeletal muscle. Two reasons that are often used to explain the development of insulin resistance include: poor diet (e.g. high sugar and/or high fat coupled with excess calories) and a lack of physical activity. However, more recently, a lack of sleep has been raised as another critical behavioral factor contributing to insulin resistance. Thus, targeting a healthy diet, activity and sleep pattern is thought to prevent the transition from health to insulin resistance and type 2 diabetes.
