Ren Gaofei, Ma Xiaojun, Jiao Pengfei
Department of Endocrinology, The First Affiliated Hospital of Zhengzhou University Zhengzhou 450052, Henan, China.
Department of Respiratory, The First Affiliated Hospital of Zhengzhou University Zhengzhou 450052, Henan, China.
Am J Transl Res. 2022 May 15;14(5):3207-3215. eCollection 2022.
To investigate the effect of liraglutide combined with metformin or acarbose on glucose control in patients with type 2 diabetes mellitus (T2DM) and to analyze the risk factors of gastrointestinal adverse reactions.
This retrospective study was conducted on 88 T2DM patients who were treated in our hospital from February 2019 to August 2021. The patients were divided into Group A (n=40) and Group B (n=48) according to different treatment methods. Group A was treated with liraglutide and metformin, while Group B was given liraglutide and acarbose. The effects of glucose control (FPG, 2hPG, HbA1c), inflammatory indexes (IL-6, CRP, SAA), fasting C-peptide, 2-h postprandial C-peptide levels and adverse reactions were compared. Afterwards, The risk factors of gastrointestinal adverse reactions were assessed via logistics regression.
It was found that the FPG, 2hPG and HbA1c levels after treatment were lower than those before treatment (P<0.05), and the levels in group A were lower than those in group B (P<0.05). The serum IL-6, CRP and SAA levels after treatment were lower than those before treatment (P<0.05), but there was no marked difference between the two groups after treatment (P>0.05). The fasting C-peptide and 2-h postprandial C-peptide levels in group A after treatment were higher than those in group B (P<0.05). Logistics regression analysis revealed that complicated digestive system diseases and combined use of acarbose were independent risk factors.
Compared with liraglutide and acarbose, liraglutide and metformin has better glucose control effect in T2DM. Although there is no obvious difference in eliminating inflammation, liraglutide combined with acarbose will increase the incidence of gastrointestinal adverse reactions in patients. So, liraglutide combined with metformin is recommended for T2DM treatment.
探讨利拉鲁肽联合二甲双胍或阿卡波糖对2型糖尿病（T2DM）患者血糖控制的影响，并分析胃肠道不良反应的危险因素。
本回顾性研究对2019年2月至2021年8月在我院接受治疗的88例T2DM患者进行。根据不同治疗方法将患者分为A组（n = 40）和B组（n = 48）。A组接受利拉鲁肽和二甲双胍治疗，而B组给予利拉鲁肽和阿卡波糖。比较血糖控制效果（空腹血糖、餐后2小时血糖、糖化血红蛋白）、炎症指标（白细胞介素-6、C反应蛋白、血清淀粉样蛋白A）、空腹C肽、餐后2小时C肽水平及不良反应。之后，通过逻辑回归评估胃肠道不良反应的危险因素。
发现治疗后空腹血糖、餐后2小时血糖和糖化血红蛋白水平低于治疗前（P < 0.05），且A组水平低于B组（P < 0.05）。治疗后血清白细胞介素-6、C反应蛋白和血清淀粉样蛋白A水平低于治疗前（P < 0.05），但两组治疗后无明显差异（P > 0.05）。A组治疗后空腹C肽和餐后2小时C肽水平高于B组（P < 0.05）。逻辑回归分析显示，消化系统疾病合并症和阿卡波糖的联合使用是独立危险因素。
与利拉鲁肽和阿卡波糖相比，利拉鲁肽和二甲双胍对T2DM患者血糖控制效果更好。虽然在消除炎症方面无明显差异，但利拉鲁肽联合阿卡波糖会增加患者胃肠道不良反应的发生率。因此，推荐利拉鲁肽联合二甲双胍用于T2DM治疗。
