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利拉鲁肽对胆囊排空的影响:一项在超重或肥胖成年人中进行的随机、安慰剂对照试验。

Effects of liraglutide on gallbladder emptying: A randomized, placebo-controlled trial in adults with overweight or obesity.

机构信息

Clinical Metabolic Physiology, Steno Diabetes Center Copenhagen, Gentofte Hospital, Hellerup, Denmark.

Department of Clinical Pharmacology, Novo Nordisk A/S, Søborg, Denmark.

出版信息

Diabetes Obes Metab. 2018 Nov;20(11):2557-2564. doi: 10.1111/dom.13420. Epub 2018 Jul 10.

Abstract

AIMS

Treatment with liraglutide 3.0 mg has been associated with gallbladder-related adverse events. To conduct a single-centre, double-blind, 12-week trial comparing the effect of 0.6 mg liraglutide and steady-state liraglutide 3.0 mg with placebo on gallbladder emptying in adults with body mass index (BMI) ≥27 kg/m and without diabetes.

METHODS

Participants were randomized 1:1 to once-daily subcutaneous liraglutide (n = 26) or placebo (n = 26), starting at 0.6 mg with 0.6-mg weekly increments to 3.0 mg, with nutritional and physical activity counselling. A 600-kcal (23.7 g fat) liquid meal test was performed at baseline, after the first dose and after 12 weeks. The primary endpoint was the 12-week maximum postprandial gallbladder ejection fraction (GBEF ), measured over 240 minutes after starting the meal.

RESULTS

Baseline characteristics were similar between groups (mean ± SD overall age 47.6 ± 10.0 years, BMI 32.6 ±3.4 kg/m , 50% women). Mean 12-week GBEF (treatment difference -3.7%, 95% confidence interval [CI] -13.1, 5.7) and area under the GBEF curve in the first 60 minutes (-390% × min, 95% CI -919, 140) did not differ for liraglutide 3.0 mg (n = 23) vs placebo (n = 24). The median (range) time to GBEF was 151 (11-240) minutes with liraglutide 3.0 mg and 77 (22-212) minutes with placebo. Similar findings were noted after the first 0.6-mg liraglutide dose. Gastrointestinal disorders, notably nausea and constipation, were the most frequently reported adverse events.

CONCLUSIONS

Treatment with liraglutide did not affect the GBEF but appeared to prolong the time to GBEF .

摘要

目的

使用利拉鲁肽 3.0mg 治疗与胆囊相关的不良事件有关。进行一项为期 12 周的单中心、双盲、随机对照试验,比较 0.6mg 利拉鲁肽和稳态利拉鲁肽 3.0mg 与安慰剂对 BMI≥27kg/m²且无糖尿病的成年人胆囊排空的影响。

方法

参与者按 1:1 随机分为每日一次皮下注射利拉鲁肽(n=26)或安慰剂(n=26)组,起始剂量为 0.6mg,每周增加 0.6mg,直至 3.0mg,并进行营养和身体活动咨询。在基线、首次给药后和 12 周时进行 600 卡路里(23.7g 脂肪)的液体餐试验。主要终点是餐后 12 周时最大餐后胆囊排空分数(GBEF),在开始进食后 240 分钟内进行测量。

结果

两组的基线特征相似(总体年龄为 47.6±10.0 岁,BMI 为 32.6±3.4kg/m²,女性占 50%)。利拉鲁肽 3.0mg(n=23)与安慰剂(n=24)组 12 周时的平均 GBEF(治疗差异-3.7%,95%置信区间[CI]-13.1,5.7)和前 60 分钟的 GBEF 曲线下面积(-390%×min,95%CI-919,140)无差异。利拉鲁肽 3.0mg 的 GBEF 中位数(范围)时间为 151(11-240)分钟,安慰剂组为 77(22-212)分钟。首次给予 0.6mg 利拉鲁肽后也观察到了类似的结果。胃肠道疾病,特别是恶心和便秘,是最常报告的不良事件。

结论

使用利拉鲁肽治疗不会影响 GBEF,但似乎延长了 GBEF 的时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbd4/6220792/53fe9546c9b4/DOM-20-2557-g002.jpg

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