GLP-1受体激动剂利拉鲁肽对2型糖尿病患者结肠镜检查肠道准备质量的影响

Effect of GLP-1 receptor agonist liraglutide on the quality of bowel preparation for colonoscopy in patients with type 2 diabetes

目的:探讨人胰升糖素样肽1(glucagonlike peptide-1,GLP-1)受体激动剂利拉鲁肽对2型糖尿病患者结肠镜检查肠道准备质量的影响。方法:前瞻性纳入2014年11月至2017年10月首次行结肠镜检查且接受口服降糖药物联用利拉鲁肽或胰岛素治疗的2型糖尿病患者195例,以聚乙二醇电解质散4L分次口服方案进行肠道准备,采用渥太华肠道准备评分量表(Ottawa Bowel Preparat ion Scale,OBPS)和肠道准备满意度(OBPS评分≤6分)比例评估肠道准备质量。结果:口服降糖药物联用利拉鲁肽(利拉鲁肽组)87例,联用胰岛素(胰岛素组)108例,2组基线资料具有可比性(P>0.05)。利拉鲁肽组和胰岛素组OBPS评分相似(5.86±1.74 vs 5.54±1.81,t=1.270,P=0.206),肠道准备满意率相似(81.6%vs 82.4%,χ~2=0.021,P=0.885)。2组肠道准备期间均未见低血糖事件发生。结论:GLP-1受体激动剂利拉鲁肽对2型糖尿病患者结肠镜检查肠道准备质量的影响较小。

Objective： To evaluate the effect of glucagonlike peptide-1 （GLP-1） receptor agonist liraglutide on the quality of bowel preparation for colonoscopy in patients with type 2 diabetes. Methods： A series of 195 patients with type 2 diabetes mellitus received oral hypoglycemic drugs combined liraglutide or insulin and underwent the first colonoscopy were prospectively enrolled from November 2014 to October 2017. The same split-dose 4 L polyethylene glycol was used for bowel cleansing. The Ottawa Bowel Preparation Scale （OBPS） and satisfactory bowel preparation （OBPS score of 6 or less） were used to assess the quality of bowel preparation. Results： In this series, 87 patients accepted oral hypoglycemic drugs combined liraglutide （the liraglutide group）, and 108 patients accepted oral hypoglycemic drugs combined with insulin （the insulin group）. The baseline data of the 2 groups were comparable （P〉0.05）. The OBPS scores （5.86±1.74 vs 5.54±1.81, t=1.270, P=0.206）, and the satisfaction bowel preparation rate were similar （81.6% vs 82.4%, χ^2=0.021, P=0.885） between the liraglutide group and the insulin groups （P〉0.05）. There were no hypoglycemic events in the 2 groups during the bowel preparation. Conclusion： The GLP-1 receptor agonist liraglutide has little effect on the quality of bowel preparation for colonoscopy in patients with diabetes mellitus. Keywords： GLP-1 receptor agonist; liraglutide; diabetes mellitus; colonoscopy; bowel preparatio