Association between use of liraglutide and liver fibrosis in patients with type 2 diabetes.
Association between use of liraglutide and liver fibrosis in patients with type 2 diabetes.
复制标题
2型糖尿病患者使用利拉鲁肽与肝纤维化的关系
DOI：
10.3389/fendo.2022.935180
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发表时间：
2022
影响因子：
5.2
通讯作者：
中科院分区：
文献类型：
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目的2型糖尿病患者发生非酒精性脂肪性肝病（NAFLD）及相关肝纤维化的风险较高。胰高血糖素样肽-1受体激动剂（GLP-1RAs）已被证明对改善NAFLD有疗效，但其对2型糖尿病患者肝纤维化的疗效有限。材料/方法对2型糖尿病患者进行前瞻性队列研究。根据是否使用利拉鲁肽将研究对象分为两组，并进行倾向评分匹配（PSM）。随访12个月后，采用NAFLD纤维化评分（NFS）、纤维化-4 （FIB-4）和肝硬度测量（LSM）评估肝纤维化。采用多变量线性回归分析利拉鲁肽使用与肝纤维化的关系。结果本研究共纳入1765例2型糖尿病患者。利拉鲁肽服用者262例，非服用者1503例。经过12个月的随访，利拉鲁肽的使用倾向于降低晚期纤维化的患病率（3.1%对6.1%,P = 0.218）。在校正混杂因素后，多变量线性回归显示利拉鲁肽的使用与2型糖尿病患者NFS （β= -0.34, P = 0.043）、FIB4 （β= -0.26, P = 0.044）和LSM （β= -4.95, P = 0.007）的降低呈负相关。PSM后的结果与PSM前相似。结论利拉鲁肽治疗可降低2型糖尿病患者的肝纤维化。
Objective Patients with type 2 diabetes have a high risk of non-alcoholic fatty liver disease (NAFLD) and related liver fibrosis. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated efficacy in improving NAFLD, while their effectiveness on liver fibrosis is limited in type 2 diabetic patients. Materials/Methods A prospective cohort study was performed in type 2 diabetic patients. The study subjects were divided into two groups based on the use of liraglutide or not, and propensity score matching (PSM) was also conducted. After 12 months follow-up, liver fibrosis was assessed by NAFLD fibrosis score (NFS) fibrosis-4 (FIB-4), and liver stiffness measurement (LSM). The association between liraglutide use and liver fibrosis was analyzed by multivariable linear regression. Results In the current study, a total of 1,765 type 2 diabetic patients were enrolled. 262 patients were liraglutide user and 1,503 were nouser. After 12 months follow-up, liraglutide use tended to be associated with reduced prevalence of advanced fibrosis (3.1% vs. 6.1%, P = 0.218). After adjustment for confounding factors, multivariable linear regression revealed that liraglutide use was negatively associated with decreased NFS (β= -0.34, P = 0.043), FIB4 (β= -0.26, P = 0.044) and LSM (β= -4.95, P = 0.007) in type 2 diabetics. The results after PSM were similar to those before PSM. Conclusions Liraglutide treatment is associated with decreased liver fibrosis in type 2 diabetic subjects.