Objective: To investigate the effect of Liraglutide on platelet distribution width(PDW) and carotid intima-media thickness(cIMT) in type 2 diabetic mellitus patients with obesity. Methods: Randomized controlled trial. A total of 80 type 2 diabetes mellitus (T2DM) obese patients with unsatisfactory glucose control were prospectively enrolled in this study from the Department of Endocrinology of Yuhuangding Hospital Affiliated to Qingdao University from January to December 2021. All the participants were treated with metformin or sulfonylureas. They were randomly divided into two groups: Liraglutide treatment group (Li group, n=40) and Control group (Con group, n=40).The Li group started the treatment with Liraglutide on the basis of the original hypoglycemic agents and the Con group was treated with metformin and sulfonylurea. After 16 weeks of treatment, the changes of PDW, cIMT and body mass index (BMI) in the two groups were observed, multiple linear regression was uesd to analyze the influencing factors of cIMT variation, and the effect of liraglutide on PDW and cIMT in obese patients with type 2 diabetes was analyzed. Results: Finally, 38 patients completed the study in Li group, including 23 males and 15 females, aged 30-69(56±11) years. All 40 patients in Con group completed the study, including 18 males and 22 females, aged 39-67(59±7) years. After 16 weeks of treatment, the levels of PDW and cIMT in Li group were (12.8±1.6) fl and (0.85±0.08) mm, respectively, lower than those before treatment (15.0±1.6) fl and (1.14±0.10) mm (t=18.61 and 20.37, respectively, both P<0.001); The PDW and cIMT in Con group were (13.6±1.5) fl and (1.05±0.10) mm, respectively, lower than those before treatment (15.0±1.5) fl and (1.13±0.13) mm (t=17.42 and 9.65, respectively, both P<0.001). The levels of fasting plasma glucose (FPG) and total cholesterol (TC) in both groups were lower than those before treatment(all P<0.001). After the treatment, the levels of PDW, cIMT, FPG and TC in Li group were lower than those in Con group (all P<0.05). The changes of PDW and cIMT before and after the treatment in Li group were (2.2±0.7) fl and (0.30±0.09) mm, respectively, higher than those in the Con group [(1.4±0.5) fl and (0.09±0.06) mm], with a statistically significant difference (both P<0.001). The changes of FPG and TC in Li group were significantly higher than those in Con group (all P<0.05). Multiple linear regression analysis showed that liraglutide, the changes of TC and systolic blood pressure (SBP) were the influencing factors for the changes of cIMT [β (95%CI) were 0.20 (0.17-0.23), 0.03 (0.01-0.06), 0.01 (0.00-0.01), respectively, all P<0.05] Conclusion: Liraglutide treatment could reduce PDW and cIMT, thus contributing to cardiovascular benefits.
目的： 观察利拉鲁肽对2型糖尿病肥胖患者血小板分布宽度（PDW）和颈动脉内膜中层厚度（cIMT）的影响。 方法： 随机对照研究。前瞻性选取2021年1至12月于青岛大学附属烟台毓璜顶医院内分泌科收治的口服二甲双胍或磺脲类药物血糖控制不佳的2型糖尿病肥胖患者80例，采用随机数字表法分为利拉鲁肽组和对照组，两组各40例，利拉鲁肽组在原口服降糖药物基础上加用利拉鲁肽治疗，对照组采用二甲双胍+磺脲类药物治疗，均治疗16周后，观察两组PDW、cIMT、空腹血糖（FPG）、总胆固醇（TC）及体质指数（BMI）等指标的变化，采用多重线性回归分析cIMT变化量的影响因素，分析利拉鲁肽对2型糖尿病肥胖患者PDW和cIMT的影响。 结果： 利拉鲁肽组最终共38例患者完成研究，其中男23例，女15例，年龄30~69（56±11）岁；对照组40例患者均完成研究，男18例，女22例，年龄39~67（59±7）岁。治疗16周后，利拉鲁肽组的PDW及cIMT分别为（12.8±1.6）fl、（0.85±0.08）mm，均低于治疗前的（15.0±1.6）fl、（1.14±0.10）mm（t分别为18.61、20.37，均P<0.001）；对照组PDW及cIMT分别为（13.6±1.5）fl、（1.05±0.10）mm，均低于治疗前的（15.0±1.5）fl、（1.13±0.13）mm（t分别为17.42、9.65，P均<0.001）。两组FPG、TC等均低于治疗前（均P<0.001）。治疗后两组间比较，利拉鲁肽组PDW、cIMT、FPG及TC均低于对照组（均P<0.05）。两组治疗前、后各指标的变化量（用Δ表示），利拉鲁肽组ΔPDW、ΔcIMT分别为（2.2±0.7）fl、（0.30±0.09）mm，高于对照组［（1.4±0.5）fl、（0.09±0.06）mm］，差异有统计学意义（均P<0.001）。利拉鲁肽组ΔFPG、ΔTC均超过对照组，差异均有统计学意义（均P<0.05）。多重线性回归分析显示，利拉鲁肽、ΔTC及收缩压的变化量是ΔcIMT的影响因素［β值（95%CI）分别为0.20（0.17~0.23），0.03（0.01~0.06），0.01（0.00~0.01），均P<0.05］。 结论： 利拉鲁肽可降低2型糖尿病肥胖患者的PDW和cIMT，使患者的心血管获益。.