Seufert J, Bailey T, Barkholt Christensen S, Nauck M A
Division of Endocrinology and Diabetology Department of Internal Medicine II, University Hospital of Freiburg, Freiburg, Germany.
AMCR Institute Inc, Escondido, CA, USA.
Diabetes Obes Metab. 2016 Jul;18(7):721-4. doi: 10.1111/dom.12623. Epub 2016 Jan 28.
This meta-analysis of seven randomized, placebo-controlled studies (total 3222 patients) evaluated whether type 2 diabetes (T2D) duration affects the changes in blood glucose control and body weight that can be achieved with liraglutide and placebo. With liraglutide 1.2 mg, shorter diabetes duration was associated with a significantly greater, but clinically non-relevant, difference in glycated haemoglobin (HbA1c) reduction (p < 0.05), i.e. a 0.18% (1.96 mmol/mol) reduction in HbA1c per 10 years shorter diabetes duration. With liraglutide 1.8 mg, shorter diabetes duration was associated with a small but statistically significant trend for greater fasting plasma glucose (FPG) reduction (p < 0.05), i.e. a 0.38 mmol/l reduction in FPG per 10 years shorter diabetes duration. Neither the liraglutide 1.8 mg nor placebo results showed a significant association between HbA1c and diabetes duration and neither the liraglutide 1.2 mg nor placebo results showed a significant association between FPG and diabetes duration. Likewise, neither liraglutide nor placebo showed a significant association between change in weight and diabetes duration. These results suggest diabetes duration has a clinically negligible effect on achievable blood glucose control and weight outcomes with liraglutide and placebo in patients with T2D.
这项对7项随机、安慰剂对照研究(共3222例患者)的荟萃分析评估了2型糖尿病(T2D)病程是否会影响利拉鲁肽和安慰剂在血糖控制及体重变化方面的效果。使用1.2mg利拉鲁肽时,糖尿病病程较短与糖化血红蛋白(HbA1c)降低幅度存在显著更大但临床意义不大的差异相关(p<0.05),即糖尿病病程每缩短10年,HbA1c降低0.18%(1.96mmol/mol)。使用1.8mg利拉鲁肽时,糖尿病病程较短与空腹血糖(FPG)降低存在虽小但有统计学意义的趋势相关(p<0.05),即糖尿病病程每缩短10年,FPG降低0.38mmol/L。1.8mg利拉鲁肽和安慰剂的结果均未显示HbA1c与糖尿病病程之间存在显著关联,1.2mg利拉鲁肽和安慰剂的结果也均未显示FPG与糖尿病病程之间存在显著关联。同样,利拉鲁肽和安慰剂均未显示体重变化与糖尿病病程之间存在显著关联。这些结果表明,在T2D患者中,糖尿病病程对使用利拉鲁肽和安慰剂所能达到的血糖控制及体重结果的临床影响可忽略不计。