The Association between GLP-1 Receptor-Based Agonists and the Incidence of Asthma in Patients with Type 2 Diabetes and/or Obesity:A Meta-Analysis

Objective Recent studies have indicated potential anti-inflammatory effects of glucagon-like peptide-1 receptor agonists(GLP-1RAs)on asthma,which is often comorbid with type 2 diabetes mellitus(T2DM)and obesity.Therefore,we conducted a meta-analysis to assess the association between the administration of glucagon-like peptide-1(GLP-1)receptor-based agonists and the incidence of asthma in patients with T2DM and/or obesity.Methods PubMed,Web of Science,Embase,the Cochrane Central Register of Controlled Trials,and Clinicaltrial.gov were systematically searched from inception to July 2023.Randomized controlled trials(RCTs)of GLP-1 receptor-based agonists(GLP-1RA,GLP-1 based dual and triple receptor agonist)with reports of asthma events were included.Outcomes were computed as risk ratios(RR)using a fixedeffects model.Results Overall,39 RCTs with a total of 85,755 participants were included.Compared to non-GLP-1 receptor-based agonist users,a trend of reduced risk of asthma was observed in patients with T2DM or obesity using GLP-1 receptor-based agonist treatments,although the difference was not statistically significant[RR=0.91,95%confidence interval(CI):0.68 to 1.24].Further Subgroup analyses indicated that the use of light-molecular-weight GLP-1RAs might be associated with a reduced the risk of asthma when compared with non-users(RR=0.65,95%CI:0.43 to 0.99,P=0.043).We also performed sensitivity analyses for participant characteristics,study design,drug structure,duration of action,and drug subtypes.However,no significant associations were observed.Conclusion Compared with non-users,a modest reduction in the incidence of asthma was observed in patients with T2DM or obesity using GLP-1 receptor-based agonist treatments.Further investigations are warranted to assess the association between GLP-1 receptor-based agonists and the risk of asthma.

Combining GLP-1 receptor agonists and SGLT-2 inhibitors for cardiovascular disease prevention in type 2 diabetes:A systematic review with multiple network meta-regressions

BACKGROUND Glucagon-like peptide-1 receptor agonists(GLP-1RA)and sodium-glucose co-transporter-2 inhibitors(SGLT-2I)are associated with significant cardiovascular benefit in type 2 diabetes(T2D).However,GLP-1RA or SGLT-2I alone may not improve some cardiovascular outcomes in patients with prior cardiovascular co-morbidities.AIM To explore whether combining GLP-1RA and SGLT-2I can achieve additional benefit in preventing cardiovascular diseases in T2D.METHODS The systematic review was conducted according to PRISMA recommendations.The protocol was registered on PROSPERO(ID:42022385007).A total of 107049 participants from eligible cardiovascular outcomes trials of GLP-1RA and SGLT-2I were included in network meta-regressions to estimate cardiovascular benefit of the combination treatment.Effect modification of prior myocardial infarction(MI)and heart failure(HF)was also explored to provide clinical insight as to when the INTRODUCTION The macro-and micro-vascular benefits of glucagon-like peptide-1 receptor agonists(GLP-1RA)and sodium-glucose co-transporter-2 inhibitors(SGLT-2I)are independent of their glucose-lowering effects[1].In patients with type 2 diabetes(T2D),the major cardiovascular outcome trials(CVOT)showed that dipeptidyl peptidase-4 inhibitors(DPP-4I)did not improve cardiovascular outcomes[2],whereas cardiovascular benefit of GLP-1RA or SGLT-2I was significant[3,4].Further subgroup analyses indicated that the background cardiovascular risk should be considered when examining the cardiovascular outcomes of these newer glucose-lowering medications.For instance,prevention of major adverse cardiovascular events(MACE)was only seen in those patients with baseline atherosclerotic cardiovascular disease[3,4].Moreover,a series of CVOT conducted in patients with heart failure(HF)have demonstrated that(compared with placebo)SGLT-2I significantly reduced risk of hospitalization for HF or cardiovascular death,irrespective of their history of T2D[5-8].However,similar cardiovascular benefits were not observed in those with myocardial infarction(MI)[9,10].Cardiovascular co-morbidities are not only approximately twice as common but are also associated with dispropor-tionately worse cardiovascular outcomes in patients with T2D,compared to the general population[11].Therefore,it is of clinical importance to investigate whether the combination treatment of GLP-1RA and SGLT-2I could achieve greater cardiovascular benefit,particularly when considering patients with cardiovascular co-morbidities who may not gain sufficient cardiovascular protection from the monotherapies.This systematic review with multiple network meta-regressions was mainly aimed to explore whether combining GLP-1RA and SGLT-2I can provide additional cardiovascular benefit in T2D.Cardiovascular outcomes of these newer antidiabetic medications were also estimated under effect modification of prior cardiovascular diseases.This was to provide clinical insight as to when the combination treatment might be prioritized.

A Retrospective Analysis of Glucagon-Like Peptide 1 Receptor Agonists in Treating Type 2 Diabetes Mellitus Complicated by Nonalcoholic Fatty Liver Disease

Background: The objective of this study was to compare and analyze the variations in clinical indices before and after treatment of type 2 mellitus (T2DM) combined with nonalcoholic fatty liver disease (NAFLD) that were treated with glucagon-like peptide 1 receptor agonists (GLP-1RAs). Methods: The electronic medical record system was utilized to search for a total of 16 patients with type 2 diabetes complicated by NAFLD who were hospitalized at the First Affiliated Hospital of Yangtze University from October 2022 to April 2023 and treated with GLP-1RA for the first time. The clinical indices were compared before and after 12 weeks of treatment with GLP-1RA. Results: The liver-spleen CT ratio (L/S), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) in all patients treated with GLP-1RA after 12 weeks were significantly different (P 0.05). The patients were categorized into two groups based on the types of GLP-1RAs. The changes in L/S, TC, TG, and LDL-C in the long-acting group after treatment were statistically significant (P Conclusions: GLP-1RAs can improve liver function, regulate lipid metabolism, and reduce the severity of fatty liver in patients with T2DM complicated by NAFLD, which demonstrates the importance of clinical applications.

Non-alcoholic fatty liver disease in type 2 diabetes:Emerging evidence of benefit of peroxisome proliferator-activated receptors agonists and incretin-based therapies

Nonalcoholic fatty liver disease(NAFLD)is a global epidemic,affecting more than half of the people living with type 2 diabetes(T2D).The relationship between NAFLD and T2D is bidirectional and the presence of one perpetuates the other,which significantly increases the hepatic as well as extrahepatic complications.Until recently,there was no approved pharmacological treatment for NAFLD/nonalcoholic steatohepatitits(NASH).However,there is evidence that drugs used for diabetes may have beneficial effects on NAFLD.Insulin sensitizers acting through peroxisome proliferator-activated receptor(PPAR)modulation act on multiple levels of NAFLD pathogenesis.Pioglitazone(PPARγ agonist)and saroglitazar(PPARα/γagonist)are particularly beneficial and recommended by several authoritative bodies for treating NAFLD in T2D,although data on biopsyproven NASH are lacking with the latter.Initial data on elafibanor(PPARα/δ agonist)and Lanifibranor(pan PPAR agonist)are promising.On the other hand,incretin therapies based on glucagon-like peptide-1(GLP-1)receptor agonists(GLP-1RA)and dual-and triple-hormone receptor co-agonists reported impressive weight loss and may have anti-inflammatory and antifibrotic properties.GLP-1 RAs have shown beneficial effects on NAFLD/NASH and more studies on potential direct effects on liver function by dual-and triple-agonists are required.Furthermore,the long-term safety of these therapies in NAFLD needs to be established.Collaborative efforts among healthcare providers such as primary care doctors,hepatologists,and endocrinologists are warranted for selecting patients for the best possible management of NAFLD in T2D.

Determination of Ten Kinds of Alpha-2 Agonists Residues in Animal Derived Food by UHPLC-Triple Quadrupole/Composite Linear Ion Trap Mass Spectrometry

[Objectives]The paper was to establish an ultra high performance liquid chromatography-quadrupole/linear ion trap complex mass spectrometry for the determination of 10 kinds ofα2-receptor agonists in animal derived food.[Methods]The samples were extracted with sodium carbonate buffer solution and ethyl acetate,and analyzed by mass spectrometry after solid phase extraction and high performance liquid chromatography separation.[Results]Ten kinds ofα2-receptor agonists showed a good linear relationship in the range of 1-100μg/mL,with the average recovery of over 69%and the relative standard deviation less than 8.32%.The detection limit of 10 kinds of α_(2)-receptor agonists was up to 1μg/kg.[Conclusions]The method has good selectivity and strong anti-interference ability,and can meet the requirements of 10 kinds ofα2-receptor agonists residues in animal derived food.

Understanding the link between type 2 diabetes mellitus and Parkinson's disease:role of brain insulin resistance

Type 2 diabetes mellitus and Parkinson's disease are chronic diseases linked to a growing pandemic that affects older adults and causes significant socio-economic burden.Epidemiological data supporting a close relationship between these two aging-related diseases have resulted in the investigation of shared pathophysiological molecular mechanisms.Impaired insulin signaling in the brain has gained increasing attention during the last decade and has been suggested to contribute to the development of Parkinson's disease through the dysregulation of several pathological processes.The contribution of type 2 diabetes mellitus and insulin resistance in neurodegeneration in Parkinson's disease,with emphasis on brain insulin resistance,is extensively discussed in this article and new therapeutic strategies targeting this pathological link are presented and reviewed.

Activation of β_2-Adrenergic Receptor Induced by Three Catecholamine Agonists:a Docking and Molecular Dynamics Study

We studied the activation of β2-adrenergic receptor（β2AR） by norepinephrine, epinephrine and isoprote- renol using docking and molecular dynamics（MD） simulation. The simulation was done on the assumption that β2AR was surrounded with explicit water and infinite lipid bilayer membrane at body temperature. So the result should be close to that under the physiological conditions. We calculated the structure of binding sites in β2AR for the three ac- tivators. We also simulated the change of the conformation ofβ2AR in the transmembrane regions（TMs）, in the mo- lecular switches, and in the conserved DRY（Aspartic acid, Arginine and Tyrosine） motif. This study provides detailed information concerning the structure ofβ2AR during activation process.

The influence of β_2AR polymorphisms as a predictor of successful short acting β_2-agonist nebulization during asthmatic exacerbation

Aim:In this study,we would like to determine associations between β2-Adrenergic Receptor(β2AR)polymorphisms at codon 16 and 27 and the response to short acting β2-agonist during asthmatic exacerbation.Methods:This was a prospective cross-sectional study of one year duration.One hundred and thirty two asthmatic patients were recruited.Five mls of venous blood was taken for DNA extraction and then genotyped for the β2AR polymorphisms using multiplex PCR.Patient's clinical responses to β2-agonist nebulization were then compared to their genotype to determine the association.Results:We found that there was no association between β2AR polymorphisms at both codon 16 and 27 with response towards short acting β2-agonist,P=0.315 and P=0.706 respectively.Conclusion:We suggested that β2AR polymorphisms at both codon 16 and 27 had no influent on the response to short acting β2-agonist.

糖皮质激素和长效β_2受体激动剂联合吸入治疗稳定期慢性阻塞性肺疾病的临床研究

目的评价吸入型糖皮质激素(ICS)和长效β2受体激动剂(LABA)联合吸入对慢性阻塞性肺疾病(COPD)稳定期患者的疗效。方法60例稳定期的中至重度COPD患者随机分为试验组和对照组。试验组给予ICS/LABA混合吸入剂(舒利迭)吸入,对照组给予LABA干粉吸入剂(施立稳)吸入,1吸/次,2次/d,疗程均为3个月。对比两组治疗前后临床症状积分和肺功能变化。结果53例患者完成本试验(试验组26例,对照组27例)。治疗后两组临床症状积分分别较治疗前明显降低,其差异有统计学意义(分别P<0.05),两组FEV1/FVC和FEV1%预计值分别较治疗前明显升高,差异有统计学意义(分别P<0.05);治疗后试验组FEV1/FVC和FEV1%预计值也分别高于对照组,差异有统计学意义(分别P<0.05)。结论对于稳定期COPD患者来说,联合吸入ICS和LABA能明显改善肺功能,减轻症状,提高生活质量。

新型β_2激动剂SPFF对豚鼠气道的扩张作用研究

目的考察SPFF对组胺和乙酰胆碱所致气管收缩的抑制作用。方法离体豚鼠气管条和豚鼠引喘试验。结果SPFF可完全抑制组胺所引起的气管收缩作用 ,但不能完全抑制乙酰胆碱所引起的气管收缩。SPFF灌胃给药时对由于组胺和乙酰胆碱混合喷雾所引起的豚鼠喘息具有显著的保护作用 ,其作用强于同剂量的沙丁胺醇。

β_2-肾上腺素能受体激动剂福莫特罗的合成工艺研究

设计了一条合成新型 β2 肾上腺素能受体激动剂福莫特罗的新路线 ,该路线较文献路线简捷方便 ,且后处理简单 ,由原料 1 (4 苄氧基 3 硝基苯基 ) 2 溴乙酮出发 ,总收率为 13 4% .适于实验室制备和工业化生产 .

两种β_2受体激动剂快速免疫检测方法

分别以偶氮方法和碳化二亚胺（ＥＤＣ）方法将β２受体激动剂克伦特罗（ＣＬ）和塞曼特罗（ＣＩＭ）连接到载体蛋白上，并以连接物免疫家兔，分别制备兔抗ＣＬ和ＣＩＭ抗血清，经间接ＥＬＩＳＡ和间接抑制ＥＬＩＳＡ检测抗血清效价和特异性，并在此基础上建立了ＣＬ和ＣＩＭ快速免疫检测方法。２种抗血清工作浓度分别为１∶１００００和１∶５０００。ＣＬ和ＣＩＭ免疫检测范围分别为１．９ｎｇ～１５．６μｇ和０．４７７ｎｇ～１．８５μｇ。２种β２受体激动剂快速免疫检测方法的建立为监督畜牧生产上滥用ＣＬ和ＣＩＭ，检测肉品ＣＬ和ＣＩＭ残留提供了一种简便、灵敏、特异的手段。

高血压病患者淋巴细胞肾上腺素能β_2受体密度与心脏不同几何构型的关系

目的 :研究高血压病患者外周血淋巴细胞 β2 受体密度与心脏不同几何构型之间的关系。方法 :采用放射性配基结合分析法 ,测定不同心脏构型高血压病患者 91例外周血淋巴细胞的 β2 受体密度 ,并与正常人 31例对照。结果 :与对照组比较 ,向心性重构 (CCR)及向心性肥厚 (CCH)组 β2 受体密度显著增加 ,离心性肥厚 (ECH)组 β2 受体密度显著减少 ,而正常几何构型 (NG)组无明显变化。结论 :高血压病患者外周血淋巴细胞 β2 受体密度与其心脏的几何构型有关。

电喷雾电离-四极杆飞行时间质谱法研究三种β_2-受体激动剂的质谱裂解特征

采用电喷雾电离 -四极杆飞行时间质谱 ( ESI-Qq TOFMS)联用技术 ,对三种β2 -受体激动剂克仑特罗( Clenbuterol)、沙丁胺醇 ( Salbutamol)和盐酸 SPFF进行碰撞诱导解离 ( Collision induced dissociation,CID)研究。将三种药物标准品用甲醇溶解至 0 .1μg/m L直接进样 ,选择正离子方式进行检测。以质子化准分子离子 [M+H]+ 作为内标物 ,对碎片离子进行了准确质量测定 ,确认了这些碎片离子的元素组成 ,探讨了该类化合物的质谱裂解规律。研究发现 :它们的 ESI-MS2质谱分别生成脱去 H2 O分子、叔丁氨基等的碎片离子 ,其中叔丁氨基碎片离子 ( m/z74)为三种药物共有的碎片离子 ,这些特征可为 β2 -受体激动剂类药物的体内代谢转化和定量分析研究提供有力的依据。

不同HRCT表型的COPD患者对长效β_2受体激动剂/吸入型糖皮质激素的治疗应答性比较

目的:探讨不同高分辨CT(HRCT)表型的慢性阻塞性肺疾病(COPD)患者对长效β_2受体激动剂/吸入型糖皮质激素治疗的应答性。方法:选取217例COPD患者,根据HRCT表现分为A型72例、E型80例和M型65例,观察3组治疗前、后肺功能情况[第1秒用力呼气容积占预计值百分比(FEV_1%预计值)、残气量占预计值百分比(RV%预计值)、深吸气量占预计值百分比(IC%预计值)、FEV_1/FVC、肺总量百分比(TLC%预计值)、第1秒用力呼气容积(FEV_1)、肺总量(TLC)、深吸气量(IC)、残气量(RV)]。结果:M型体重指数(BMI)为(20.12±3.22)kg/m^2,明显低于A型和E型组(P<0.05);M型组FEV_1%预计值和RV%预计值分别为(47.52±9.80)%和(138.89±52.29)%,明显低于A型和E型组(均P<0.05),IC%预计值为(87.71±13.26)%,明显高于A型和E型组(P<0.05)。治疗后A型组FEV_1、TLC、IC和RV改善值分别为(0.35±0.09)L、(-0.53±0.12)L、(0.17±0.06)L和(-0.60±0.11)L,明显优于E型和M型组(均P<0.05)。结论:不同HRCT表型的COPD患者对长效β_2受体激动剂/吸入型糖皮质激素的治疗存在差异,其中A型COPD的疗效较好,肺功能改善明显。

基质分离固相萃取-液相色谱-串联质谱法快速测定牛肉中4种β_2-受体激动剂类兽药残留

目的建立基质分离固相萃取结合液相色谱串联质谱法(liquidchromatographytandemmass spectrometry, LC-MS/MS)快速测定牛肉中克伦特罗、莱克多巴胺、沙丁胺醇、特布他林等4种β_(2)-受体激动剂类兽药残留。方法样品经葡萄糖醛苷酶/硫酸酯酶酶解、盐析后经CNW兽药定量检测分散固相萃取纯化包净化。采用LC-MS/MS电喷雾正离子模式、多反应监测采集(multiple reaction monitoring acquisition, MRM)测定。结果当4种β_(2)-受体激动剂类兽药化合物空白样本加标水平在2.5、12.5、50μg/kg时,回收率为95.39%~106.59%,相对标准偏差(relative standard deviation, RSD)为0.98%~13.26%。4种目标化合物的检出限为0.1~0.3μg/kg,定量限为0.3~1.0μg/kg。针对市售66件牛肉样品中目标化合物进行检测,结果均未检出。结论与传统通过性固相萃取法相比,兽药定量检测分散固相萃取纯化法净化效果更好,基质效应更低。CNW兽药定量检测分散固相萃取法可用于牛肉中克伦特罗、莱克多巴胺、沙丁胺醇、特布他林4种β_(2)-受体激动剂类兽药残留快速检测。

液相色谱—串联质谱法测定动物源性食品中4种β_2^-受体激动剂类药物残留

建立了动物源性食品中4种β2-受体激动剂克伦特罗、莱克多巴胺、沙丁胺醇和特布他林的高效液相色谱—串联质谱测定方法。样品经5%的三氯乙酸酸解提取,Waters Oasis MCX固相萃取柱净化,然后用Aglient ZORBAXSB-Aq(3.5μm,3.0 mm×100 mm)色谱柱分离,以0.1%甲酸乙腈溶液和0.1%甲酸水溶液为流动相进行梯度洗脱,基质匹配标准溶液内标法定量。结果表明,4种β2-受体激动剂在质量浓度1.0~100 g/L内呈良好的线性关系,相关系数R均大于0.995 0;检出限(S/N≥3)均为0.1μg/kg,定量下限(S/N≥10)为0.25 g/kg,在0.5,2,5μg/kg3个质量分数添加水平,回收率在81%~108%,相对标准偏差在1.3%~9.4%。方法灵敏度高、定性准确可用于各种动物源性食品中4种β2-受体激动剂残留的快速检测。

β_2-受体激动剂治疗新生儿暂时性呼吸急促

目的探讨吸入β2-受体激动剂(舒喘灵)治疗新生儿暂时性呼吸急促(transient Tachypnea of the Newborn TTN)的疗效,并确定新生儿吸入舒喘灵的安全性.方法将2011年10月至2014年6月入住昆明市妇幼保健院的100例TTN患儿随机分为吸入舒喘灵组(治疗组)52人,未吸入组(对照组)48人,胎龄37周至40+3周.治疗组通过舒喘灵喷雾瓶、储雾罩在入院60 min、6 h分别给予0.4 mg舒喘灵气雾剂吸入;对照组按常规治疗.结果 (1)2组患儿在入院后7、12、24 h呼吸急促、呻吟、吸凹征严重程度比较,治疗组较对照组明显减轻和持续时间明显缩短,差异有统计学意义(P<0.05);(2)治疗组用药前后心率无明显增加,2组心率统计学处理,差异无统计学意义(P>0.05);(3)舒喘灵组需要常压给氧、n CPAP治疗时间较对照组缩短,差异有统计学意义(P<0.05);(4)机械通气治疗:舒喘灵组1例(1.9%)、对照组6例(12.5%),差异有统计学意义(P<0.05);(5)2组入院后12 h监测平均p H值、氧分压、二氧化碳分压转归情况比较,差异有统计学意义(P<0.05);(6)在研究过程中,心电监护无1例心律失常发生;52例治疗组患儿均未出现肌肉震颤症状.结论吸入舒喘灵对新生儿暂时性呼吸急促治疗有明显疗效.且临床和实验室检查均未发现不良反应.

长效β_2-受体激动剂预混表面激素治疗慢性阻塞性肺疾病疗效观察

目的 :探讨吸入型肾上腺糖皮质激素 (表面激素 )与长效β2 -受体激动剂 (LABA)的预混制剂对慢性阻塞性肺疾病 (COPD)的治疗作用。方法 :Ⅲ期 (重度 )COPD病人 33例 ,全部病例入组前无使用过任何剂型的激素、β -受体激动剂、抗胆碱药 ,无氧疗史。随机分成两组 ,A组 1 7例 ,吸入丙酸氟替卡松 沙美特罗 (舒利迭TM5 0 2 5 0 )干粉剂 ,1吸 次 ,2次 d ;B组 1 6例 ,无吸入上述药物 ;两组病人均服用舒弗美 0 .2 q1 2h、沐舒坦 30mg tid ,必要时短期吸氧 (<2W ) ,均无使用抗胆碱药 ,观察治疗 4W、1 2W、2 4W三个时间点病人临床症状、健康状态、生活质量和肺功能。结果 :观察期各不同时间点A、B两组临床症状、急性加重发生次数及严重度、健康状态和生活质量等各项观察指标差异有显著性 ,A组明显优于B组 ,P <0 .0 5 ;且随疗程A组呈逐步改善 ,B组改善不明显。结论 :表面激素与LABA治疗COPD具有良好协同作用 ,其预混制剂使用方便 ,病人依从性高 ,近期疗效好 ,有一定的临床应用价值 。

达格列净联合胰高血糖素样肽-1受体激动剂对2型糖尿病的疗效研究

目的探讨达格列净联合胰高血糖素样肽-1受体激动剂(GLP-1 RAs)对2型糖尿病患者血液流变学及胰岛素抵抗的影响。方法将2020年11月—2022年10月泉州市中医院收治的102例2型糖尿病患者随机分为2组,每组51例。对照组给予达格列净治疗,研究组采用达格列净联合GLP-1 RAs(利拉鲁肽)的治疗方案。比较2组临床疗效、血糖指标[空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)]、空腹胰岛素(FINS)及胰岛素抵抗[胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)]、血脂指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、血液流变学指标[红细胞聚集指数(EAI)、红细胞压积(HCT)、红细胞变形指数(EDI)、血浆黏度(PV)]和不良反应。结果研究组总有效率为94.12%,高于对照组的80.39%,差异有统计学意义(P<0.05)。研究组和对照组治疗后FBG、2 hPG、HbAlc、BMI均低于治疗前,且研究组治疗后FBG、2 hPG、HbAlc水平低于对照组,差异有统计学意义(P<0.05)。治疗后,研究组FINS、HOMA-β水平高于对照组,HOMA-IR水平低于对照组,差异有统计学意义(P<0.05)。研究组和对照组治疗后HDL-C均高于治疗前,TC、TG、LDL-C水平均低于治疗前;研究组治疗后HDL-C水平高于对照组,TC、TG、LDL-C水平低于对照组,差异均有统计学意义(P<0.05)。治疗后,研究组和对照组EAI、HCT、EDI、PV水平均低于治疗前,且研究组EAI、HCT、EDI、PV水平低于对照组,差异均有统计学意义(P<0.05)。研究组不良反应总发生率为11.76%,与对照组的9.80%比较,差异无统计学意义(P>0.05)。结论达格列净联合GLP-1 RAs(利拉鲁肽)治疗2型糖尿病的疗效确切,可有效调节患者血糖及血脂水平,缓解胰岛素抵抗,改善血液流变学指标。