The Effect Of Liraglutide On Vascular Endothelial Function In Type 2 Diabetes

Objective: The major cause of death and disability in type 2 diabetes mellitus(T2DM)is macroangiopathy complications,moreover endothelial dysfunction is considered as an initial event at the onset of macroangiopathy complications.As a consequence,for T2 DM,controlling glucose as well as attenuating endotheliel dysfunction plays a crucial role in the development of atherosclerosis and cardiovascular disease(CVD).As a novel safety treatment,GLP-1 analogue can directly affect endothelium,improve endothelial function.Liraglutide is one of GLP-1 analogue,which may have a role of endothelial function protection.However,so far,the findings of studies display inconsistent.Therefore,we aimed to demonstrate the effects of liraglutide on vascular endothelial function in T2 DM,and try to explore underlying protective mechanisms.Methods : 42 subjects with T2 DM were enrolled at the xxx Medical University,endocrinology department from December 2013 to December 2016,including 36 males and 6 females.Before treatment of liraglutide,standard height and body weight were measured,and body mass index(BMI)was calculated.The fasting blood samples were collected to detected fasting plasma blood(FPG),glycosylated hemoglobin(Hb A1c),fasting c-peptide(FCP),total cholesterol(TC),tiglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),C-reactive protein(CRP)by automatic biochemical analyzer.Homeostasis model assessment of insulin resistance(HOMA-IR)and islet β cell function(HOMA-β)were Computed using FPG and FCP.The ankle-brachial index(ABI),brachial-ankle pulse wave velocity(ba-PWV)and flow mediated dilation(FMD)were accessed.Then the subjects were treated with liraglutide.After three months,aforementioned indexes were detected again.The effects of liraglutide on these indexes were analyzed by paired sample t test.Results:1.Body weight decreased from(90.94±12.39)kg to(87.13±12.37)kg,and BMI decreased from(29.79±3.08)kg/m2 to(28.55±3.07)kg/m2,they were both decreased 4.2% after treatment of liraglutide,the difference was statistically significant(P<0.001).2.Compared with pre-treatment,Hb A1 c from(8.45±1.71)to(7.16±1.55)and FPG from(8.90±2.02)mmol/L to(8.05±2.16)mmol/L,decreased 15.3% and 9.6%respectively,after three-month treatment of Liraglutide,the difference was statistically significant(P<0.001).However,the others like HOMA-IR and HOMA-β were not significantly improved(P>0.05).3.Among blood lipid,TG level to was significantly lower from(2.72±0.25)mmol/L to(1.87±1.17)mmol/L,after treatment of liraglutide than the baseline level(P < 0.05),but the differences of TC,LDL-C,HDL-C was no statistically significance(P>0.05).4.CRP was not significant difference between before and after treatment(P > 0.05).5.There were no significant differences in ba-pwv between before and after liraglutide treatment(P<0.05).However,the right side ABI from(1.15±0.10)to(1.11±0.07),decreased 3.5% and the difference was statistically significant(P<0.05).6.After three-month treatment of Liraglutide,although FMD had improved compared with pre-treatment,there were no significant statistically(P<0.05).Conclusion:1.Liraglutide can significantly reduce body weight,BMI,Hb A1 c,FPG and the level of TG,but it could not significantly improve insulin resistance and islet β-cell function.2.Liraglutide can decrease the right side ABI,but it failed to improve the ba-pwv.3.In this study,Liraglutide failed to significantly improve FMD.Further research needed to do though matching age,gender and history of T2 DM,enlarging the sample size and extending the duration of treatment.