Warwick Medical School, University of Warwick, Coventry, UK.
BMJ Open. 2013 Jan 24;3(1):e001986. doi: 10.1136/bmjopen-2012-001986.
To synthesise current evidence for the effects of exenatide and liraglutide on heart rate, blood pressure and body weight.
Meta-analysis of available data from randomised controlled trials comparing Glucagon-like peptide-1 (GLP-1) analogues with placebo, active antidiabetic drug therapy or lifestyle intervention.
Patients with type 2 diabetes.
Weighted mean differences between trial arms for changes in heart rate, blood pressure and body weight, after a minimum of 12-week follow-up.
32 trials were included. Overall, GLP-1 agonists increased the heart rate by 1.86 beats/min (bpm) (95% CI 0.85 to 2.87) versus placebo and 1.90 bpm (1.30 to 2.50) versus active control. This effect was more evident for liraglutide and exenatide long-acting release than for exenatide twice daily. GLP-1 agonists decreased systolic blood pressure by -1.79 mm Hg (-2.94 to -0.64) and -2.39 mm Hg (-3.35 to -1.42) compared to placebo and active control, respectively. Reduction in diastolic blood pressure failed to reach statistical significance (-0.54 mm Hg (-1.15 to 0.07) vs placebo and -0.50 mm Hg (-1.24 to 0.24) vs active control). Body weight decreased by -3.31 kg (-4.05 to -2.57) compared to active control, but by only -1.22 kg (-1.51 to -0.93) compared to placebo.
GLP-1 analogues are associated with a small increase in heart rate and modest reductions in body weight and blood pressure. Mechanisms underlying the rise in heart rate require further investigation.
综合目前关于 exenatide 和 liraglutide 对心率、血压和体重影响的证据。
对比较胰高血糖素样肽-1（GLP-1）类似物与安慰剂、活性抗糖尿病药物治疗或生活方式干预的随机对照试验的现有数据进行荟萃分析。
2 型糖尿病患者。
经过至少 12 周随访后，试验组之间心率、血压和体重变化的加权均数差值。
共纳入 32 项试验。总体而言，GLP-1 激动剂与安慰剂相比使心率增加 1.86 次/分（95%CI 0.85 至 2.87），与活性对照相比增加 1.90 次/分（1.30 至 2.50）。这种作用在利拉鲁肽和 exenatide 长效释放制剂中比在 exenatide 每日两次更明显。GLP-1 激动剂与安慰剂和活性对照相比，收缩压分别降低了-1.79mmHg（-2.94 至-0.64）和-2.39mmHg（-3.35 至-1.42）。舒张压降低未达到统计学意义（与安慰剂相比为-0.54mmHg（-1.15 至 0.07），与活性对照相比为-0.50mmHg（-1.24 至 0.24））。与活性对照相比，体重降低了-3.31kg（-4.05 至-2.57），但与安慰剂相比仅降低了-1.22kg（-1.51 至-0.93）。
GLP-1 类似物与心率略有升高、体重和血压适度降低有关。心率升高的机制需要进一步研究。
