从糖尿病的心血管疾病风险看GLP-1类似物  

GLP-1 analogues prevent cardiovascular risks in diabetics

作　　者：陆菊明[1] 

机构地区：[1]解放军总医院内分泌科,北京100853

出　　处：《中华内分泌代谢杂志》2010年第4期353-356,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：2型糖尿病与心血管疾病风险密切相关。对于具有多重心血管危险因素的糖尿病患者，在安全有效控制血糖的同时，应强调全面强化干预血脂、血压等并存风险因素，才能有效降低糖尿病大血管病变的发生，带来良好的心血管益处。美国食品药品监督管理局（FDA）也强调需要考虑降糖药物的心血管方面的安全性。胰升糖素样肽1（GLP—1）具有葡萄糖浓度依赖性降糖作用及β细胞保护功能，此外还可减轻体重，并具有独特的的心血管保护效应。利拉鲁肽（Liraglutide）与人GLP-1的高度同源性充分保留了GLP-1的多项生理活性，同时作用于2型糖尿病的多个病理生理靶点，发挥GLP-1的多效作用。LEAD（Liraglutide Effect and Actionin Diabetes）等研究结果证实，无论其单独应用还是与其他口服降糖药联用利拉鲁肽显示了优异的降糖效果，且出现低血糖风险很低。利拉鲁肽可通过降低血压，减轻体重全面干预多种心血管疾病危险因素，显示了GLP-1在心血管风险因素防控方面独特的优势。Type 2 diabetes mellitus is closely linked with cardiovascular diseases. Successful management of type 2 diabetes mellitus requires effective and safe control of glycemia, as well as comprehensive intervention of other risk factors, such as hypertension and overweight, to effectively reduce the occurrence of diabetic macrovaseular complications. FDA also stressed the need to evaluate cardiovascular safety of new hypoglycemic drugs. The recent evidence suggests glucagons-like peptide-1 （ GLP-1 ） may address many of the needs of diabetes treatment such as glucose concentration-dependent hypoglycemic and β-cell protection, low risk of hypoglycemia, weight loss, and unique cardiovascular protection. Liraglutide is one of human GLP-1 analogues with high homology to the native hormone. A comprehensive phase III（ Liraglutide Effect and Action in Diabetes, LEAD ） program showed that once-daily liraglutide significantly improved glucose control with low rates of hypoglycemia occurrence. Additional beneficial effects of liraglutide on body weight, systolic blood pressure, and other cardiovascular benefits were also documented, suggesting the unique advantages of GLP-1 analogue in cardiovascular disease risk prevention.

关 键 词：糖尿病 2型 心血管风险 胰升糖素样肽1 利拉鲁肽 

分 类 号：R587.1[医药卫生—内分泌]