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利拉鲁肽对体重、糖化血红蛋白和血压的影响:沙特阿拉伯东部省份的单中心经验

Liraglutide Effect on Weight, Glycated Hemoglobin, and Blood Pressure: A Single-Center Experience in the Eastern Province of Saudi Arabia.

作者信息

Alsafwani Duaa M, Alotaibi Hind N, Alzaid Jawaher A, Alghamdi Amal, Almakhaita Huda M

机构信息

Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU.

出版信息

Cureus. 2022 Mar 27;14(3):e23554. doi: 10.7759/cureus.23554. eCollection 2022 Mar.

Abstract

Background Liraglutide has pleiotropic effects beneficial to patients with cardiovascular and renal risks. These effects have been linked to weight and blood pressure reduction in type 2 diabetes (T2D) patients. However, whether this reduction is similar in all patients regardless of their ethnicity, baseline demographic, or clinical characteristics is unknown. This study aimed to identify the efficacy of liraglutide on weight, glycated hemoglobin (HbA1c), and blood pressure in Saudi patients with T2D who attended King Fahad Hospital of the University and received liraglutide as add-on therapy to other antihyperglycemic agents. The study also aimed to describe the pattern of change in these clinical parameters before and after the treatment and assess whether sex differences affect liraglutide's efficacy. Methods We conducted a retrospective longitudinal study reviewing medical records of 220 Saudi patients with T2D treated at King Fahad Hospital of the University (KFHU), in Al-Khobar city in the Eastern Province of Saudi Arabia, from December 2016 to November 2021. Patient cases were included if the patient was Saudi, aged 18 or older, and received liraglutide in a dose of at least 0.6 mg/day for at least three months in combination with other antihyperglycemic agents/diabetes medications. We recorded the effect on patient HbA1c, systolic blood pressure (SBP) and diastolic blood pressure (DBP), body mass index (BMI), and body weight at baseline, during, and after treatment. We used the paired t-test and repeated measure analysis of variance to compare the mean study parameters before and after treatment. Furthermore, an independent t-test was used to compare the mean study parameters among men and women. Results Treatment with liraglutide from 0.6 mg/day to 3 mg/day for three to 18 months had optimal results across the outcomes measured in our cohort study. There was a significant reduction in weight from baseline to 18 months from a mean weight of 97.9±20 kg to 96.51±18.45 kg with (p<0.001). Mean HbA1c at baseline was 9.34%±1.95%, dropped to 7.67%±1.11% (p<0.001) at 18 months. Moreover, mean SBP also significantly decreased from 126.61±10.4 mmHg to 122.48±7.29 mmHg by the last follow-up (p<0.001). Mean DBP was 76.54±8.37 mmHg at baseline and decreased to 74.29±6.22 mmHg at last follow-up (p<0.001). Men treated with liraglutide had greater reductions in weight than women throughout the study (p<0.05), and while men had greater reductions in SBP and DBP than women early in treatment (p<0.05), by the end of treatment, there were no significant differences in blood pressure between men and women. Likewise, we saw no significant difference between HbA1c reductions in men and women treated with liraglutide. Conclusion Liraglutide effectively reduces HbA1c, weight, BMI, SBP, and DBP in T2D patients. These study results reflect real-world liraglutide clinical practices from KFHU and can be beneficial for physicians when considering using liraglutide as add-on therapy in this population.

摘要

背景

利拉鲁肽具有多种有益作用,对有心血管和肾脏风险的患者有益。这些作用与2型糖尿病(T2D)患者体重减轻和血压降低有关。然而,无论患者的种族、基线人口统计学特征或临床特征如何,这种降低是否在所有患者中都相似尚不清楚。本研究旨在确定利拉鲁肽对在法赫德国王大学医院就诊并接受利拉鲁肽作为其他降糖药物附加治疗的沙特T2D患者的体重、糖化血红蛋白(HbA1c)和血压的疗效。该研究还旨在描述治疗前后这些临床参数的变化模式,并评估性别差异是否影响利拉鲁肽的疗效。

方法

我们进行了一项回顾性纵向研究,回顾了2016年12月至2021年11月在沙特阿拉伯东部省胡巴尔市法赫德国王大学医院(KFHU)接受治疗的220例沙特T2D患者的病历。纳入标准为患者为沙特人,年龄在18岁及以上,接受至少0.6 mg/天剂量的利拉鲁肽治疗至少三个月,并联合其他降糖药物/糖尿病药物。我们记录了治疗前、治疗期间和治疗后对患者HbA1c、收缩压(SBP)和舒张压(DBP)、体重指数(BMI)和体重的影响。我们使用配对t检验和重复测量方差分析来比较治疗前后的平均研究参数。此外,使用独立t检验来比较男性和女性之间的平均研究参数。

结果

在我们的队列研究中,使用0.6 mg/天至3 mg/天的利拉鲁肽治疗三至18个月,在所有测量结果中均取得了最佳效果。从基线到18个月,体重显著降低,平均体重从97.9±20 kg降至96.51±18.45 kg(p<0.001)。基线时平均HbA1c为9.34%±1.95%,在18个月时降至7.67%±1.11%(p<0.001)。此外,到最后一次随访时,平均SBP也从126.61±10.4 mmHg显著降至122.48±7.29 mmHg(p<0.00)。基线时平均DBP为76.54±8.37 mmHg,在最后一次随访时降至74.29±6.22 mmHg(p<0.001)。在整个研究过程中,接受利拉鲁肽治疗的男性体重减轻幅度大于女性(p<0.05),虽然在治疗早期男性SBP和DBP的降低幅度大于女性(p<0.05),但在治疗结束时,男性和女性之间的血压没有显著差异。同样,我们发现接受利拉鲁肽治疗的男性和女性在HbA1c降低方面没有显著差异。

结论

利拉鲁肽可有效降低T2D患者的HbA1c、体重、BMI、SBP和DBP。这些研究结果反映了KFHU的利拉鲁肽实际临床应用情况,对医生在考虑将利拉鲁肽作为该人群的附加治疗药物时可能有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4dc/8958214/935abd68978c/cureus-0014-00000023554-i01.jpg

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