Said Olena V, Velychko Valentyna I, Danylchuk Halyna O
Odessa National Medical University, Odessa, Ukraine.
Wiad Lek. 2018;71(6):1141-1146.
Introduction: Long-term systemic inflammation may cause type 2 diabetes. Medications used to treat type 2 diabetes don't target inflammation therefore it's necessary to study how hypoglycemics can improve patient prognosis through modification of systemic inflammation. The aim: Our goal was to assess influence of liraglutide in complex therapy on proinflammatory cytokine levels in overweight patients with type 2 diabetes and compare it with metformin.
Meterials and methods: The study included 80 overweight patients with type 2 diabetes. We studied clinical parameters as well as antropometric: height, weight, BMI, abdomen circumference; hsCRP, proinflammatory cytokine (TNF-α, IL-1β, IL-6) levels. Patients were treated according to an individualized treatment plan which included eating habit modification and dosed physical exercise. First and second groups were comparison groups. Patients in the first group received metformin as primary treatment up to 2500 mg/day (n=20). Patients in the second group received liraglutide up to 1.8 mg/day (n=30). Patients in the third (main) group received a combination of metformin (up to 2500 mg/day) and liraglutide up to 1.8 mg/day (n=30).
Results and conclusions: Main group achieved a decrease in BMI from 28,48±2,1 kg/m2 to 23,9±1,8 kg/m2 (р<0,05), whereas such decrease in the liraglutide monotherapy group was from 28,59±2,5 kg/m2 to 25,87±2,3 kg/m2 (р<0,05) and from 28,65±3,2 kg/m2 to 27,46±2,8 kg/m2 (р>0,05) in the metformin monotherapy group. Liraglutide was more efficient in lowering inflammatory cytokine concentrations with TNF-α and IL-6 being more sensitive to its effects. Main group saw a decrease in TNF-α levels from 10,14±0,6 to 7,49±0,33 pg/ml (<0,001) and IL-6 levels from 11,12±0,7 to 7,84±0,62 pg/ml (<0,001).
引言：长期全身性炎症可能导致2型糖尿病。用于治疗2型糖尿病的药物并不针对炎症，因此有必要研究降糖药如何通过调节全身性炎症来改善患者预后。目的：我们的目标是评估利拉鲁肽在联合治疗中对超重2型糖尿病患者促炎细胞因子水平的影响，并将其与二甲双胍进行比较。
材料与方法：该研究纳入了80例超重2型糖尿病患者。我们研究了临床参数以及人体测量指标：身高、体重、体重指数（BMI）、腹围；超敏C反应蛋白（hsCRP）、促炎细胞因子（肿瘤坏死因子-α、白细胞介素-1β、白细胞介素-6）水平。患者根据个性化治疗方案进行治疗，该方案包括饮食习惯调整和定量体育锻炼。第一组和第二组为对照组。第一组患者接受二甲双胍作为初始治疗，剂量高达2500毫克/天（n = 20）。第二组患者接受利拉鲁肽，剂量高达1.8毫克/天（n = 30）。第三组（主要）患者接受二甲双胍（剂量高达2500毫克/天）和利拉鲁肽（剂量高达1.8毫克/天）的联合治疗（n = 30）。
结果与结论：主要组的BMI从28.48±2.1千克/平方米降至23.9±1.8千克/平方米（р<0.05），而利拉鲁肽单药治疗组的这种下降是从28.59±2.5千克/平方米降至25.87±2.3千克/平方米（р<0.05），二甲双胍单药治疗组则从28.65±3.2千克/平方米降至27.46±2.8千克/平方米（р>0.05）。利拉鲁肽在降低炎症细胞因子浓度方面更有效，肿瘤坏死因子-α和白细胞介素-6对其作用更敏感。主要组的肿瘤坏死因子-α水平从10.14±0.6降至7.49±0.33皮克/毫升（<0.001），白细胞介素-6水平从11.12±0.7降至7.84±0.62皮克/毫升（<0.001）。
