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Diabetes Obes Metab：胰高血糖素样肽1受体激动剂与2型糖尿病患者的微血管结局

2018-08-01 xing.T MedSci原创

胰高血糖素样肽1受体激动剂2型糖尿病微血管结局
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总之，GLP-1 RA对于肾病和视网膜病变相关的结局是安全的。但对于玻璃体出血可能需要谨慎。证据总体质量较低表明在未来的试验中需要突出一致性评估和报告微血管终点。

近日，代谢内分泌疾病领域权威杂志Diabetes Obesity & Metabolism上发表了一篇研究文章，研究人员对评估胰高血糖素样肽1受体激动剂（GLP-1 RAs）对成年2型糖尿病患者微血管终点影响的随机对照试验进行了系统评价和荟萃分析。

研究人员纳入了60项研究，共有60077名患者。与安慰剂或其他抗糖尿病药物相比，GLP-1 RA可以略微降低患者的尿白蛋白与肌酐比值（加权平均差[WMD]分别为-2.55mg/g; 95％可信区间[CI]为-4.37至-0.73和-5.52; -10.89至-0.16），并且对估计的肾小球滤过率的变化没有临床相关影响。

无论对照剂为何，用GLP-1 RA治疗都不会增加糖尿病视网膜病变、黄斑水肿、视网膜脱离和视网膜出血的发生率。然而，与安慰剂相比，用GLP-1 RA治疗的受试者的玻璃体出血发生率更高（OR为1.93; 95％CI为1.09至3.42）。

总之，GLP-1 RA对于肾病和视网膜病变相关的结局是安全的。但对于玻璃体出血可能需要谨慎。证据总体质量较低表明在未来的试验中需要突出一致性评估和报告微血管终点。

原始出处：

Ioannis Avgerinos,et al. Glucagon‐like peptide 1 receptor agonists and microvascular outcomes in type 2 diabetes: a systematic review and meta‐analysis.Diabetes Obesity & Metaibolsm.2018. https://doi.org/10.1111/dom.13484

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    2019-04-13 12498fa0m11暂无昵称

    #胰高血糖素样肽1#

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    2018-09-18 guojianrong

    #Meta#

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    2018-12-26 一闲

    #MET#

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createdBy=d8f4110, createdName=guojianrong, createdTime=Tue Sep 18 14:33:00 CST 2018, time=2018-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896356, encodeId=8336189635657, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Wed Dec 26 05:33:00 CST 2018, time=2018-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1638710, encodeId=01a51638e10c7, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Tue Mar 05 21:33:00 CST 2019, time=2019-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1945068, encodeId=e02819450683c, content=<a href='/topic/show?id=1d198401200' target=_blank style='color:#2F92EE;'>#胰高血糖素样肽1受体激动剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84012, encryptionId=1d198401200, topicName=胰高血糖素样肽1受体激动剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ffd5416, createdName=bettycmoon, createdTime=Sat Dec 08 23:33:00 CST 2018, time=2018-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1760765, encodeId=d99d1e607653d, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Tue Apr 02 03:33:00 CST 2019, time=2019-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1902104, encodeId=27a21902104bd, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Tue Sep 04 04:33:00 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261159, encodeId=c1bc1261159ee, content=<a href='/topic/show?id=30c6102e2607' target=_blank style='color:#2F92EE;'>#高血糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102726, encryptionId=30c6102e2607, topicName=高血糖)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1365347, encodeId=2db5136534eb4, content=<a href='/topic/show?id=2a2150e76fd' target=_blank style='color:#2F92EE;'>#微血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50776, encryptionId=2a2150e76fd, topicName=微血管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383462, encodeId=abbf13834624d, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=)]
    2019-03-05 ms9608593228839890

    #DIA#

    0

  5. 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objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Tue Apr 02 03:33:00 CST 2019, time=2019-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1902104, encodeId=27a21902104bd, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Tue Sep 04 04:33:00 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261159, encodeId=c1bc1261159ee, content=<a href='/topic/show?id=30c6102e2607' target=_blank style='color:#2F92EE;'>#高血糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102726, encryptionId=30c6102e2607, topicName=高血糖)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1365347, encodeId=2db5136534eb4, content=<a href='/topic/show?id=2a2150e76fd' target=_blank style='color:#2F92EE;'>#微血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50776, encryptionId=2a2150e76fd, topicName=微血管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383462, encodeId=abbf13834624d, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=)]
    2018-12-08 bettycmoon

    #胰高血糖素样肽1受体激动剂#

    0

  6. 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objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Tue Apr 02 03:33:00 CST 2019, time=2019-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1902104, encodeId=27a21902104bd, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Tue Sep 04 04:33:00 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261159, encodeId=c1bc1261159ee, content=<a href='/topic/show?id=30c6102e2607' target=_blank style='color:#2F92EE;'>#高血糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102726, encryptionId=30c6102e2607, topicName=高血糖)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1365347, encodeId=2db5136534eb4, content=<a href='/topic/show?id=2a2150e76fd' target=_blank style='color:#2F92EE;'>#微血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50776, encryptionId=2a2150e76fd, topicName=微血管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383462, encodeId=abbf13834624d, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=)]
    2019-04-02 柳叶一刀

    #BET#

    0

  7. 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objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Tue Apr 02 03:33:00 CST 2019, time=2019-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1902104, encodeId=27a21902104bd, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Tue Sep 04 04:33:00 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261159, encodeId=c1bc1261159ee, content=<a href='/topic/show?id=30c6102e2607' target=_blank style='color:#2F92EE;'>#高血糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102726, encryptionId=30c6102e2607, topicName=高血糖)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1365347, encodeId=2db5136534eb4, content=<a href='/topic/show?id=2a2150e76fd' target=_blank style='color:#2F92EE;'>#微血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50776, encryptionId=2a2150e76fd, topicName=微血管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383462, encodeId=abbf13834624d, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=)]
    2018-09-04 智慧医人

    #Diabetes#

    0

  8. 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href='/topic/show?id=30c6102e2607' target=_blank style='color:#2F92EE;'>#高血糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102726, encryptionId=30c6102e2607, topicName=高血糖)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1365347, encodeId=2db5136534eb4, content=<a href='/topic/show?id=2a2150e76fd' target=_blank style='color:#2F92EE;'>#微血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50776, encryptionId=2a2150e76fd, topicName=微血管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383462, encodeId=abbf13834624d, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=)]
    2018-08-03 hbwxf

    #高血糖#

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1809873, encodeId=ab6618098e37e, content=<a href='/topic/show?id=c37984011c9' target=_blank style='color:#2F92EE;'>#胰高血糖素样肽1#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84011, encryptionId=c37984011c9, topicName=胰高血糖素样肽1)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=278f2500221, createdName=12498fa0m11暂无昵称, createdTime=Sat Apr 13 06:33:00 CST 2019, time=2019-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887913, encodeId=8adb188e913c0, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, 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href='/topic/show?id=30c6102e2607' target=_blank style='color:#2F92EE;'>#高血糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102726, encryptionId=30c6102e2607, topicName=高血糖)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1365347, encodeId=2db5136534eb4, content=<a href='/topic/show?id=2a2150e76fd' target=_blank style='color:#2F92EE;'>#微血管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50776, encryptionId=2a2150e76fd, topicName=微血管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383462, encodeId=abbf13834624d, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=)]
    2018-08-03 mgqwxj

    #微血管#

    0

  10. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383462, encodeId=abbf13834624d, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Fri Aug 03 00:33:00 CST 2018, time=2018-08-03, status=1, ipAttribution=)]
    2018-08-03 aids213

    #2型糖尿病患者#

    0

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