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胰高血糖素样肽-1(GLP-1)受体激动剂度拉糖肽对日本2型糖尿病患者代谢参数的真实世界疗效:一项回顾性纵向研究

Real-World Efficacy of Glucagon-like Peptide-1 (GLP-1) Receptor Agonist, Dulaglutide, on Metabolic Parameters in Japanese Patients with Type 2 Diabetes: A Retrospective Longitudinal Study.

作者信息

Katsuyama Hisayuki, Hakoshima Mariko, Umeyama Shohei, Iida Sakura, Adachi Hiroki, Yanai Hidekatsu

机构信息

Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Kohnodai Hospital, Chiba 272-8516, Japan.

出版信息

Biomedicines. 2023 Mar 13;11(3):869. doi: 10.3390/biomedicines11030869.

Abstract

The glucagon-like peptide-1 receptor agonist (GLP-1RA) dulaglutide has been shown to improve body weight and glycemic control and reduce major cardiovascular (CV) events. In Japan, dulaglutide is used at a fixed dose of 0.75 mg, which is lower than that in Europe and North America. However, the reports of real-world efficacy on metabolic parameters in Japanese patients with type 2 diabetes (T2DM) are limited. This study aimed to examine the real-world efficacy of GLP-1RA dulaglutide on metabolic parameters in Japanese patients with T2DM. We retrospectively selected patients with T2DM who had been prescribed dulaglutide continuously for 12 months or longer between September 2015 and December 2020 and compared metabolic parameters at baseline with the data at 12 months after the start of dulaglutide. One hundred twenty-one patients were enrolled in this study. The 12-month dulaglutide treatment reduced body weight by 1.7 kg and hemoglobin A1c by 1.1%. Significant improvements were also observed in serum high-density lipoprotein cholesterol (HDL-C), triglyceride (TG) and non-HDL-C. The change in HbA1c during dulaglutide treatment was significantly correlated with the changes in HDL-C (R = -0.236, = 0.013), LDL-C (R = 0.377, = 0.005) and non-HDL-C (R = 0.415, < 0.001). The improvements in HbA1c, HDL-C, TG and non-HDL-C were greater in patients concurrently treated with SGLT2 inhibitors (SGLT2is) at baseline. In conclusion, the treatment with dulaglutide has beneficial effects on multiple CV risk factors in Japanese patients with T2DM.

摘要

胰高血糖素样肽-1受体激动剂(GLP-1RA)度拉糖肽已被证明可改善体重和血糖控制,并减少主要心血管(CV)事件。在日本,度拉糖肽的使用剂量固定为0.75mg,低于欧洲和北美。然而,关于度拉糖肽在日本2型糖尿病(T2DM)患者中对代谢参数的真实疗效报道有限。本研究旨在探讨GLP-1RA度拉糖肽在日本T2DM患者中对代谢参数的真实疗效。我们回顾性选择了在2015年9月至2020年12月期间连续使用度拉糖肽12个月或更长时间的T2DM患者,并将基线时的代谢参数与度拉糖肽开始使用后12个月的数据进行比较。本研究共纳入121例患者。度拉糖肽治疗12个月可使体重减轻1.7kg,糖化血红蛋白降低1.1%。血清高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)和非HDL-C也有显著改善。度拉糖肽治疗期间HbA1c的变化与HDL-C(R = -0.236,P = 0.013)、低密度脂蛋白胆固醇(LDL-C,R = 0.377,P = 0.005)和非HDL-C(R = 0.415,P < 0.001)的变化显著相关。在基线时同时接受钠-葡萄糖协同转运蛋白2抑制剂(SGLT2is)治疗的患者中,HbA1c、HDL-C、TG和非HDL-C的改善更大。总之,度拉糖肽治疗对日本T2DM患者的多种心血管危险因素具有有益作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee55/10046001/e42279e2593b/biomedicines-11-00869-g001a.jpg

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