Department of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
Eur J Pharmacol. 2021 Feb 15;893:173823. doi: 10.1016/j.ejphar.2020.173823. Epub 2020 Dec 19.
This study was undertaken to assess the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs), mainly liraglutide and exenatide, on glycemic control and anthropometric profiles to see if they are effective in treating patients with non-alcoholic fatty liver disease (NAFLD) and type-2 diabetes mellitus (T2DM). We searched PubMed, Embase, Scopus, Web of Science (WOS), and Cochrane Library databases to identify all the randomized clinical trials (RCTs) up to August 23, 2020. Heterogeneity of the included studies was evaluated using Cochrane's Q test and the I statistic. Moreover, a random-effects model was used to pool the weighted mean differences (WMDs) and their 95% confidence intervals (CIs). Nine articles (12 studies) comprising a total of 780 participants aged 40-56 were finally selected. GLP-1RAs intake significantly reduced body mass index (BMI) (WMD -1.57, 95%CI; -2.74, -0.39), waist-circumference (WC) (WMD -4.14, 95%CI; -7.09, -1.19), body weight (WMD -4.20, 95%CI; -8.15, -0.25) among the body mass indices. Additionally, GLP-1RAs leads to lower postprandial plasma glucose (PPG) levels (WMD -25.73 mg/dl, 95%CI; -32.71, -18.75). We also found that GLP-1RAs intake has no significant effect on the waist-hip ratio (WHR) (WMD -0.01, 95%CI; -0.03, 0.02), fasting blood glucose (FBG) (WMD -2.12 mg/dl, 95%CI; -6.23, 1.96), hemoglobin A1c (HbA1c) (WMD -0.08%, 95%CI; -0.21, 0.04), and homeostatic model assessment for insulin resistance (HOMA-IR) levels (WMD -0.31, 95%CI; -0.69, 0.07). GLP-1RAs therapy showed a greater reduction in BMI, body weight, WC, and PPG, but not in WHR, HOMA-IR, FBG, and HbA1c compared with other therapies in patients with T2DM and NAFLD.
本研究旨在评估胰高血糖素样肽-1 受体激动剂（GLP-1RAs），主要是利拉鲁肽和艾塞那肽，对血糖控制和人体测量学特征的影响，以观察它们是否对非酒精性脂肪性肝病（NAFLD）和 2 型糖尿病（T2DM）患者有效。我们检索了 PubMed、Embase、Scopus、Web of Science（WOS）和 Cochrane 图书馆数据库，以确定截至 2020 年 8 月 23 日的所有随机临床试验（RCT）。使用 Cochrane's Q 检验和 I 统计评估纳入研究的异质性。此外，使用随机效应模型汇总加权均数差值（WMD）及其 95%置信区间（CI）。最终选择了 9 篇文章（12 项研究），共纳入 780 名年龄在 40-56 岁的参与者。GLP-1RA 摄入可显著降低体重指数（BMI）（WMD -1.57，95%CI；-2.74，-0.39）、腰围（WC）（WMD -4.14，95%CI；-7.09，-1.19）和体重（WMD -4.20，95%CI；-8.15，-0.25）。此外，GLP-1RA 可降低餐后血糖（PPG）水平（WMD -25.73mg/dl，95%CI；-32.71，-18.75）。我们还发现，GLP-1RA 摄入对腰臀比（WHR）（WMD -0.01，95%CI；-0.03，0.02）、空腹血糖（FBG）（WMD -2.12mg/dl，95%CI；-6.23，1.96）、糖化血红蛋白（HbA1c）（WMD -0.08%，95%CI；-0.21，0.04）和稳态模型评估的胰岛素抵抗（HOMA-IR）水平（WMD -0.31，95%CI；-0.69，0.07）无显著影响。与其他治疗方法相比，GLP-1RA 治疗在 T2DM 和 NAFLD 患者中显示出更大的 BMI、体重、WC 和 PPG 降低，但 WHR、HOMA-IR、FBG 和 HbA1c 无显著降低。
