Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China.
Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China; National Clinical Research Center for Chinese Medicine Cardiology, Beijing 100091, China.
Pharmacol Res. 2021 Sep;171:105765. doi: 10.1016/j.phrs.2021.105765. Epub 2021 Jul 9.
To evaluate the efficacy and safety of liraglutide in patients with Type 2 Diabetes Mellitus (T2DM) complicated with Coronary Artery Disease (CAD), we searched PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Chinese VIP Information (VIP), Wanfang Database and Chinese Biomedical Literature database (CBM) for relevant randomized controlled trials (RCTs) from inception to 7 October 2020. A total of 18 RCTs including 1557 patients with T2DM complicated with CAD were included. Meta-analysis revealed liraglutide reduced hemoglobin A1c (HbA1c) (WMD = -0.67; 95% CI[-0.94 to -0.39]; P < 0.00001), fasting plasma glucose (FPG) (WMD = -0.80; 95% CI[-1.06 to -0.54]; P < 0.00001) and 2 h plasma glucose (2hPG) (WMD = -1.64; 95% CI[-2.12 to -1.16]; P＜0.00001); improved left ventricular ejection fraction(LVEF) (WMD = 4.79; 95% CI[4.08-5.51]; P < 0.00001), left ventricular end-diastolic diameter (LVEDD) (WMD = -5.70; 95% CI[-6.67 to -4.72]; P＜0.00001), E/A (WMD = 0.13; 95% CI[0.11-0.14]; P < 0.00001) and left ventricular posterior wall thickness (LVPWT) (WMD = -1.86; 95% CI[-2.16 to -1.55]; P < 0.00001); reduced total cholesterol (TC) (WMD = -0.48; 95% CI[-0.56 to -0.39]; P < 0.00001), triglycerides (TG) (WMD = -0.42; 95% CI[-0.59 to -0.26]; P < 0.00001), low-density lipoprotein cholesterol (LDL-C) (WMD = -0.41; 95% CI[-0.55 to -0.26]; P < 0.00001), and increased high-density lipoprotein cholesterol (HDL-C) (WMD = -0.19; 95% CI[0.13-0.24]; P = 0.0005). As for safety assessment, liraglutide did not increase the incidence of hypoglycemia (OR = 0.75, 95% CI[0.32-1.77], P = 0.51) and gastrointestinal (OR = 1.15, 95% CI[0.72-1.85], P = 0.55) events. Consequently, liraglutide had favorable effects on blood glucose, cardiac function, lipid profile and an acceptable safety profile.
为了评估利拉鲁肽在伴有冠状动脉疾病（CAD）的 2 型糖尿病（T2DM）患者中的疗效和安全性，我们检索了从建库至 2020 年 10 月 7 日的 PubMed、Cochrane 图书馆、Embase、中国知网（CNKI）、中文科技期刊数据库（VIP）、万方数据库和中国生物医学文献数据库（CBM），以获取相关的随机对照试验（RCT）。共纳入了 18 项 RCT，包括 1557 例伴有 CAD 的 T2DM 患者。Meta 分析显示，利拉鲁肽降低了糖化血红蛋白（HbA1c）（WMD=-0.67；95%CI[-0.94 至-0.39]；P＜0.00001）、空腹血糖（FPG）（WMD=-0.80；95%CI[-1.06 至-0.54]；P＜0.00001）和 2 小时血糖（2hPG）（WMD=-1.64；95%CI[-2.12 至-1.16]；P＜0.00001）；改善了左心室射血分数（LVEF）（WMD=4.79；95%CI[4.08-5.51]；P＜0.00001）、左心室舒张末期直径（LVEDD）（WMD=-5.70；95%CI[-6.67 至-4.72]；P＜0.00001）、E/A（WMD=0.13；95%CI[0.11-0.14]；P＜0.00001）和左心室后壁厚度（LVPWT）（WMD=-1.86；95%CI[-2.16 至-1.55]；P＜0.00001）；降低了总胆固醇（TC）（WMD=-0.48；95%CI[-0.56 至-0.39]；P＜0.00001）、三酰甘油（TG）（WMD=-0.42；95%CI[-0.59 至-0.26]；P＜0.00001）、低密度脂蛋白胆固醇（LDL-C）（WMD=-0.41；95%CI[-0.55 至-0.26]；P＜0.00001），并增加了高密度脂蛋白胆固醇（HDL-C）（WMD=-0.19；95%CI[0.13-0.24]；P=0.0005）。在安全性评估方面，利拉鲁肽并未增加低血糖（OR=0.75，95%CI[0.32-1.77]，P=0.51）和胃肠道（OR=1.15，95%CI[0.72-1.85]，P=0.55）事件的发生率。因此，利拉鲁肽在血糖、心功能、血脂和安全性方面均有良好的效果。
