Division of Endocrinology and Metabolic Diseases, Department of Internal Medicine, Turgut Özal University, Malatya Training and Research Hospital, Malatya, Turkey.
Eur Rev Med Pharmacol Sci. 2022 Sep;26(18):6813-6820. doi: 10.26355/eurrev_202209_29783.
Obesity and Type 2 diabetes mellitus are growing health problems all over the world. The aim of this study is the comparison of 3 mg liraglutide and metformin combination, metformin monotherapy on the blood glucose regulation, weight loss and lipid panel in the patients with Type 2 diabetes mellitus whose BMI is ≥ 30 kg/m2.
276 patients included in the study were divided into two groups (1:1); liraglutide (3 mg) + metformin combination (L+M) and metformin monotherapy (M) (2x1,000 mg) (exercise and diet were regulated in both groups). Patients' body composition measurements were performed and fasting blood glucose, postprandial blood glucose, HbA1c, triglyceride, total cholesterol, LDL, HDL levels were measured by TANITA device prior to the therapy and in the week 12 of the therapy.
The average age of 276 patients included in the study was 49.70±7.93 years. A statistically significant decrease was noted in weight, BMI, fasting blood glucose, postprandial blood glucose, HbA1c values of both groups at the end of the third month. 11.3 kg of weight was lost on average in L+M group (-12.3%); 4.5 kg of weight was lost in the monotherapy group (-4.9%). A decrease of 14.3% was seen in the body fat mass, 2.1% in the muscle mass in L+M group and a decrease of 4.4% in the body fat mass and 6.1% in the muscle mass in the monotherapy group. The decrease in the body fat was higher at a statistically significant level in L+M group and the decrease in the muscle mass was higher in the monotherapy group. HbA1c decreased by 17.9% in L+M group (-1.49±0.46, Cohen's d=2.68), 5.3% in the monotherapy group (-0.37±0.26, Cohen's d=0.90). The decrease in TG, total cholesterol, LDL was higher at a statistically significant level in L+M group. The increase in HDL level was higher in the monotherapy group (L+M=22.7%, M=35.4%). A weight loss that was over 10% occurred in 4.3% of the patients in the monotherapy group and 68.1% of the combined therapy group at the end of 12 weeks (95% C.I. OR=19.49-121.65).
The effect of the combination of liraglutide 3 mg and metformin on blood glucose regulation, weight loss (fat loss, muscle conservation) was found to be superior to the metformin monotherapy in the obese patients with Type 2 diabetes mellitus according to the early period results.
肥胖和 2 型糖尿病是全世界日益严重的健康问题。本研究的目的是比较 3mg 利拉鲁肽和二甲双胍联合治疗与二甲双胍单药治疗对 BMI≥30kg/m2 的 2 型糖尿病患者血糖控制、体重减轻和血脂谱的影响。
将 276 例患者纳入研究并分为两组(1:1);利拉鲁肽(3mg)+二甲双胍联合治疗(L+M)和二甲双胍单药治疗(M)(2x1000mg)(两组均进行运动和饮食调节)。在治疗前和治疗第 12 周,通过 TANITA 设备测量患者的身体成分,并测量空腹血糖、餐后血糖、HbA1c、甘油三酯、总胆固醇、LDL、HDL 水平。
276 例患者的平均年龄为 49.70±7.93 岁。两组在治疗第 3 个月时体重、BMI、空腹血糖、餐后血糖、HbA1c 值均有统计学显著下降。L+M 组平均体重减轻 11.3kg(-12.3%);单药组体重减轻 4.5kg(-4.9%)。L+M 组体脂减少 14.3%,肌肉减少 2.1%;单药组体脂减少 4.4%,肌肉减少 6.1%。L+M 组体脂减少更显著,具有统计学意义,单药组肌肉减少更显著。L+M 组 HbA1c 下降 17.9%(-1.49±0.46,Cohen's d=2.68),单药组下降 5.3%(-0.37±0.26,Cohen's d=0.90)。L+M 组 TG、总胆固醇、LDL 下降更显著,具有统计学意义。单药组 HDL 水平升高更显著(L+M=22.7%,M=35.4%)。12 周结束时,单药组有 4.3%的患者体重减轻超过 10%,联合治疗组有 68.1%(95%CI OR=19.49-121.65)。
根据早期结果,与二甲双胍单药治疗相比,3mg 利拉鲁肽联合二甲双胍治疗肥胖 2 型糖尿病患者的血糖控制、体重减轻(脂肪减少、肌肉保留)效果更优。