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Aims/Introduction Glucagon‐like peptide‐1 receptor agonists (GLP‐1Ras) are widely used to treat type 2 diabetes. They not only reduce glucose, but also have a positive effect on weight loss. However, few studies have reported the effect of GLP‐1Ras on fat distribution. Materials and Methods PubMed, Cochrane, Embase and ClinicalTrials.gov were searched for randomized controlled trials on GLP‐1Ras and type 2 diabetes, published from inception to June 2021. Our main outcomes were the reductions of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). Other anthropometric outcomes were also assessed. We used the Cochrane Collaboration tools to assess the risk of bias in the included studies. The quality of the evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation profiler version 3.6. Review Manager 5.4.1 and Stata 16.0 were used for data analysis. Results A total of 10 studies involving 541 patients were included. Compared with the control groups, the GLP‐1Ras groups showed reductions in VAT (standard mean difference −0.54, 95% confidence interval [CI] −0.92, −0.17, I 2 = 79%, P = 0.005) and SAT (standard mean difference −0.44, 95% CI −0.60, −0.27, I 2 = 44%, P < 0.00001). In addition, bodyweight (weighted mean difference −3.59, 95% CI −4.30, −2.88, I 2 = 0%, P < 0.00001), waist circumference (weighted mean difference −3.09, 95% CI −4.66, −1.52, I 2 = 70%, P = 0.0001) and body mass index (weighted mean difference −1.11, 95% CI −1.35, −0.86, I 2 = 47%, P < 0.00001) were significantly decreased. According to the Grades of Recommendation, Assessment, Development and Evaluation approach, the level of evidence was low or moderate. Conclusion This study highlights that GLP‐1Ras, especially liraglutide and exenatide, might play an active role in fat distribution in patients with type 2 diabetes. After treatment with GLP‐1Ras, both VAT and SAT decreased, and the decrease of VAT was numerically greater than that of SAT.

ObjectiveIn the present network meta-analysis (NMA), we aimed to compare the effectiveness of daily and weekly treatment with glucagon-like peptide-1 receptor agonists for patients with nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM).MethodWe used Stata 17.0 for the NMA. Eligible Randomized controlled trials (RCTs) were searched in PubMed, Cochrane, and Embase databases until December 2022. Two researchers independently screened the available studies. The Cochrane Risk of Bias tool was used to assess the risk of bias in the included studies. We used GRADEprofiler (version3.6) to analyze the evidence certainty. Primary outcomes such as liver fat content (LFC), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels, as well as secondary outcomes such as γ-glutamyltransferase (γGGT) and body weight, were evaluated. Then, each intervention was ranked by the surface under the cumulative ranking curve (SUCRA). As a supplement, we drew forest plots of subgroup using RevMan (version 5.4).ResultsFourteen RCTs involving 1666 participants were included in the present study. The NMA results showed that exenatide (bid) was the best treatment for improving LFC compared with other agents, liraglutide, dulaglutide, semaglutide (qw) and placebo), and the SUCRA values were 66.8%. Among five interventions (except exenatide (bid) and semaglutide (qw)) evaluated for AST outcome, and six interventions (except exenatide (bid)) evaluated for ALT outcome, semaglutide (qd) was the most effective drug (SUCRA (AST) = 100%, SUCRA (ALT) = 95.6%). The result of LFC in daily group was MD = -3.66, 95% CI [-5.56, -1.76] and in weekly GLP-1RAs group, it was MD = -3.51, 95% CI [-4, -3.02]. As to AST and ALT, the results in daily group versus weekly group were AST: MD = -7.45, 95% CI [-14.57, -0.32] versus MD= -0.58, 95% CI [-3.18, 2.01] and ALT: MD = -11.12, 95% CI [-24.18, 1.95] versus MD = -5.62, 95% CI [-15.25, 4]. The quality of evidence was assessed as moderate or low.ConclusionThe daily GLP-1RAs may be more effective in primary outcomes. And the daily semaglutide may be the most effective treatment for NAFLD and T2DM among the six interventions.

Summary Compared with the biodegradation of coal, the co‐degradation of coal and straw can significantly improve methane production, which is potential to increase biogenic coalbed methane (CBM) production. In the laboratory tests, the succession of microbial communities and organic compounds in the process of methane generation from among degradations of coal (C), rice straw (RS), and coal‐rice straw (CRS) were investigated by using with MiSeq and GC‐MS analytical instruments. The experimental results indicated that methane production in the cultivation CRS was about 12 times higher than that of C. A shift of dominant methanogen in inoculum was observed in the process of co‐degradation from acetoclastic Methanosaeta to methylotrophic Methanomethylovorans on the seventh day, finally to hydrogenotrophic Methanobacterium. The structures of bacteria and fungi also changed significantly in the process of co‐degradation which mainly enriched macromolecules degrading and volatile fatty acids (VFAs) metabolizing microbes to facilitate methane generation. Moreover, the value of pH decreased with enrichment of VFAs, especially butanoic acid, because VFAs were dominant in the intermediates of co‐degradation. The contents of VFAs were negatively corelated with methane production during cultivation suggesting they would contribute to methane production. The component of intermediates in co‐degradation was distinct from those in cultivations of C and RS especially after 7 days as revealed by principal component analysis and heatmap analysis. These results revealed that adding rice straw into coal biodegradation changed the metabolic pathway and methanogenesis in co‐degradation.

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