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胰高血糖素样肽-1受体激动剂对2型糖尿病患者减

Glucagon-like peptide-1 (GLP-1) is a gut hormone, secreted from the intestine in response to meal ingestion, which stimulates insulin secretion and inhibits glucagon release in a dose-dependent fashion [1]. GLP-1 can suppress food intake and appetite and decelerate gastric emptying and induce satiety, so it plays an important role in regulation of blood glucose [23]. But the rapid inactivation of GLP-1 in vivo and the consequent short half-life prevents its therapeutic use.

 

Long acting GLP-1 receptor agonists (GLP-1 RAs) that can be administered via subcutaneous injection once or twice a day or even once a week have been developed [4]. GLP-1 RAs include exenatide, liraglutide, albiglutide, taspoglutide, lixise- natide and LY2189265. Treatment with GLP-1 RAs improves insulin resistance and glucose homoeostasis for patients with Type 2 DM [56]. Also they have a rather low risk of hypoglycemia because of their mode of action. Exenatide and liraglutide are currently successfully being employed in the treatment of Type 2 DM [7].

 

Overweight or obesity may increase the risk of car- diovascular complications as well as resulting in serious psychological distress for most patients with Type 2 DM [8]. Effective interventions designed to achieve weight reduction are a critical part of Type 2 DM management to prevent the development of microvascular and macrovascular compli- cations. But many antidiabetic agents (insulin, thiazolidine- diones, and sulfonylureas) have side-effect of bodyweight increase. GLP-1 can stimulate satiety by binding to its receptor on hypothalamic neurons and reduce calorie ingestion by delayed gastric emptying [910]. Although several meta- analyses have revealed the association between GLP-1 RAs and weight loss, all of them are head-to-head comparisons of GLP-1 RAs versus placebo or active comparator drugs [711– 13], and these analyses did not evaluate the impact of different doses of GLP-1 RAs on weight loss. Therefore, we did network meta-analysis of GLP-1 RAs in order to provide up-to-date overview of the effects of GLP-1 RAs on weight control in patients with Type 2 DM.