Metabolic hormones stabilize brain reward and motivational circuits, whereas excessive opioid consumption counteracts this effect and may impair metabolic function. Here we addressed the role of metabolic processes in the course of the agonist medication-assisted treatment for opioid use disorder (OUD) with buprenorphine or methadone. Plasma lipids, hemoglobin A1C, body composition, the oral glucose tolerance test (oGTT) and the Sweet Taste Test (STT) were measured in buprenorphine- (n = 26) or methadone (n = 32)- treated subjects with OUD. On the whole, the subjects in both groups were overweight or obese and insulin resistant; they displayed similar oGTT and STT performance. As compared to methadone-treated subjects, those on buprenorphine had significantly lower rates of metabolic syndrome (MetS) along with better values of the high-density lipoproteins (HDL). Subjects with- vs. without MetS tended to have greater addiction severity. Correlative analyses revealed that more buprenorphine exposure duration was associated with better HDL and opioid craving values. In contrast, more methadone exposure duration was associated with worse triglycerides-, HDL-, blood pressure-, fasting glucose- and hemoglobin A1C values. Buprenorphine appears to produce beneficial HDL- and craving effects and, contrary to methadone, its role in the metabolic derangements is not obvious. Our data call for further research aimed at understanding the distinctive features of buprenorphine metabolic effects vis-à-vis those of methadone and their potential role in these drugs' unique therapeutic profiles.

中文翻译：

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阿片类激动剂药物辅助治疗患者的代谢和成瘾指数：丁丙诺啡和美沙酮的比较。

代谢激素可稳定大脑的奖励和动机回路，而过量的阿片类药物消耗可抵消这种作用并可能损害代谢功能。在这里，我们讨论了在丁丙诺啡或美沙酮对阿片类药物使用障碍（OUD）的激动剂药物辅助治疗过程中代谢过程的作用。在接受丁丙诺啡（n = 26）或美沙酮（n = 32）治疗的OUD受试者中测量血浆脂质，血红蛋白A1C，身体组成，口服葡萄糖耐量试验（oGTT）和甜味试验（STT）。总体而言，两组受试者均超重或肥胖且胰岛素抵抗。他们展示了类似的oGTT和STT性能。与美沙酮治疗的受试者相比，丁丙诺啡的患者代谢综合征（MetS）的发生率显着降低，而高密度脂蛋白（HDL）的值则更高。患有或未患有MetS的受试者倾向于具有更高的成瘾严重性。相关分析表明，丁丙诺啡暴露时间越长，HDL和阿片类药物的渴望值就越高。相反，更多的美沙酮暴露持续时间与甘油三酯，HDL，血压，空腹血糖和血红蛋白A1C值较差有关。丁丙诺啡似乎产生有益的HDL和渴望作用，与美沙酮相反，其在代谢紊乱中的作用并不明显。我们的数据需要进一步研究，旨在了解丁丙诺啡的代谢作用相对于美沙酮的独特特征及其在这些药物中的潜在作用。