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长期观察研究 GLP-1R 激动剂对糖尿病患者肺功能的影响。

Long-term observational study on the impact of GLP-1R agonists on lung function in diabetic patients.

机构信息

Respiratory Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.

Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.

出版信息

Respir Med. 2019 Jul-Aug;154:86-92. doi: 10.1016/j.rmed.2019.06.015. Epub 2019 Jun 18.

Abstract

INTRODUCTION

Preclinical research suggests a role of Glucagon Like Peptide-1 Receptors (GLP-1R) on the regulation of human bronchial tone. We investigated the effect of GLP-1R agonists on lung function of Type 2 Diabetes Mellitus (T2DM) population without co-existing chronic obstructive respiratory disorders.

METHODS

This was a prospective cohort study that examined change in lung function measurements over two years of T2DM patients (n = 32) treated with metformin monotherapy (control cohort), metformin plus GLP-1R agonists (GLP-1R agonists cohort), or metformin plus insulin (insulin cohort).

RESULTS

After 24 months of treatment, the forced expiratory volume in 1 s (FEV) significantly (p < 0.05) increased from baseline in the GLP-1R agonists cohort (218 ml [95%CI 88-246]), but not in the control and insulin cohorts (94 ml [95%CI -28 - 216] and 26 ml [95%CI -174 - 226], respectively; p > 0.05 vs. baseline). The average increase in FEV in the GLP-1R agonists cohort was significantly greater than that in the control and insulin cohorts (delta: 110 ml [95%CI 18-202] and 177 ml [95%CI 85-270], respectively, p < 0.05). The forced vital capacity (FVC) also increased significantly more in the GLP-1R agonists cohort than in the control and insulin cohorts (overall delta FVC: 183 ml [95%CI 72-295], p < 0.05). The maximal expiratory flow at 50-75% significantly (p < 0.05) improved from baseline in the GLP-1R agonists cohort, but not in the control and insulin cohorts (p > 0.05).

CONCLUSION

Our preliminary results suggest a potential new therapeutic perspective to treat airway disorders with GLP-1R agonists.

摘要

简介

临床前研究表明,胰高血糖素样肽-1 受体 (GLP-1R) 在调节人类支气管张力方面发挥作用。我们研究了 GLP-1R 激动剂对无并存慢性阻塞性呼吸道疾病的 2 型糖尿病 (T2DM) 人群肺功能的影响。

方法

这是一项前瞻性队列研究,研究了两年内接受二甲双胍单药治疗(对照组)、二甲双胍加 GLP-1R 激动剂(GLP-1R 激动剂组)或二甲双胍加胰岛素(胰岛素组)治疗的 T2DM 患者的肺功能测量值的变化。

结果

治疗 24 个月后,GLP-1R 激动剂组的用力呼气量 1 秒 (FEV) 较基线显著增加(p<0.05,218ml[95%CI 88-246]),而对照组和胰岛素组无显著增加(94ml[95%CI-28-216]和 26ml[95%CI-174-226];p>0.05 与基线相比)。GLP-1R 激动剂组的 FEV 平均增加量明显大于对照组和胰岛素组(差值:110ml[95%CI 18-202]和 177ml[95%CI 85-270],p<0.05)。GLP-1R 激动剂组的用力肺活量 (FVC) 也比对照组和胰岛素组显著增加(总 FVC 差值:183ml[95%CI 72-295],p<0.05)。GLP-1R 激动剂组的 50-75%最大呼气流量显著改善(p<0.05),而对照组和胰岛素组无显著改善(p>0.05)。

结论

我们的初步结果表明,GLP-1R 激动剂可能为治疗气道疾病提供一种新的治疗方法。

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