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GLP-1受体激动剂对2型糖尿病患者腰围的影响

Glucagon-like peptide-1 receptor agonists(GLP-1RAS)are increasingly used in patients with type 2diabetes. However. the effect on abdominal obesity has notet been confirmed. The study aimed to systematicallevaluate the effect of GLP-IRAS on waist circumference inpatients with type 2 diabetes. MEDLINE, EMBASE, the Cochranelibraryandwww.clinicaltrialgovweresearchedthrough October 31. 2013. Randomized controlled trialswith available data were selected if they compared GLP-1
R.As with placebo and traditional anti-diabetic drugs with aduration >8 weeks. Weighted mean difference was estimated using random-effect model. Network meta-anal ysiswas performed to supplement direct comparisons. Seventeen trials with 12 treatments were included. Overall, significant reductions on waist circumference followingtreatment of liraglutide-1.8 mg once daily (-5. 24 cm,95% CI-7.68, -2 93), liraglutide-12 mg once daily 4.73 cm, 95 Cl-6.68, -2.65 )and exenatide-10 Hg twice daily (1.34 cm, 95 %o CI-2.00, -0.75) weredetected versus placebo. The reduction effect was moreevident when compared with insulin and thiazolidinediones(range -1.71 to-8.03 cm).Compared with exenatideiraglutide-0.6 mg once daily, taspoglutide, liraglutide-1.2 mg once daily and liraglutide-1.8 mg once dailysignificantly decreased waist circumference from.32 to 6.01 cm. Besides, liraglutide-1.8 mg once daily significantly decreased waist circumference by-1.73 cm(95 %o Cl-3.04, -0.55) versus sitagliptin, whereas nosignificant difference following liraglutide-1. 2-mg-oncedaily treatment was detected compared with liraglutide 1.8 mg once daily and sitagliptin Reduction was observedwith statistical significance for exenatide-10 u twicedaily compared with exenatide-5 ug twice daily(1. 21 cm, 95 CI-243, -0.06).Ranking probabilityanalysis indicated liraglutide-1. 8 mg once daily andiraglutide-1. 2 mg once daily decreased waist circumference most among all 12 treatments with probability of 98.36%o and 91.82 %, respectively. Some GLP-1RASespecially liraglutide-1.8 mg once daily and liraglutide 1.2 mg once daily, were associated with a significantreduction in waist circumference.