Effects Of Exenatide On Platelet Function In Patients With Type2 Diabetes

Objective To understand the effect of glucagon-like peptide-1(GLP-1)receptor agonist exenatide on platelet aggregation and coagulation function in patients with type 2 diabetes,with the aim of clinical application of GLP-1 receptor agonist and Provide theoretical basis for the prevention and treatment of diabetes and cardiovascular diseases.Methods Thirty newly diagnosed overweight or obese patients with type 2 diabetes who were treated in the Endocrinology Department of the First Affiliated Hospital of Anhui Medical University from October 2018 to November 2019 were selected as experimental groups.They only received lifestyle interventions without any hypoglycemia Drug treatment and anti-platelet aggregation treatment,glycosylated hemoglobin(Hb A1c)ranged from 7.5 to 10.0%.These included 20 males and 10 females,aged 22 to 62 years,with a diabetes course of 1 week to 24 months,and a body mass index(BMI)of 24.2-36.3 kg / m2.Thirty patients with normal glucose tolerance who underwent a physical examination at the Health Management Center of the First Affiliated Hospital of Anhui Medical University during the same period were selected as the control group,including 21 males and 9 females,aged 24 to 59 years,BMI 24.5-36.0 kg / m2,None had received anti-platelet aggregation therapy.Patients in the experimental group received exenatide for 8 weeks.The initial treatment was 5?g subcutaneous injection,twice daily,and 4 weeks later changed to 10 ?g subcutaneous injection,twice daily for 4 weeks.Detection of peripheral blood platelet count(PLT),plasma prothrombin time(PT),activated partial thromboplastin time(APTT),international normalized rate(INR),and fibrinogen content(FIB)in the experimental group before and after 8 weeks of treatment),Plasma thrombin time(TT),and the determination of collagen(COLL),epinephrine(EPI),arachidonic acid(ACA),adenosine diphosphate(ADP)as the inducer induced platelet aggregation function indicators.The paired t test was used to compare the changes in the observed indicators of the experimental group before and after 8 weeks of treatment.Pearson correlation analysis and multiple regression analysis were used to explore the relevant factors affecting platelet aggregation function and anticoagulant indexes before and after exenatide treatment.Results1)Compared with the control group,the levels of TG,FPG,and Hb A1 c before the treatment in the experimental group were significantly higher than those in the control group(P <0.05).Gender,age,weight,BMI,waist circumference,systolic blood pressure(SBP),and diastolic blood pressure(DBP),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C)were not significantly different(P>0.05).2)Compared with the control group,the FIB level before treatment,the platelet aggregation rate with epinephrine as the inducer,the platelet aggregation rate with adenosine diphosphate as the inducer,and the platelet aggregation rate with arachidonic acid as the inducer All were significantly higher than the control group(P<0.05).There were no significant differences in PT,PT%,INR,APTT,TT,FDP,DD,and platelet aggregation rate with collagen as the inducer between the two groups(P>0.05).3)Compared with before treatment,the body weight,BMI,waist circumference,SBP,TC,triglyceride(TG),LDL-C,fasting blood glucose(FPG),and Hb A1 c in the experimental group were significantly reduced after 8 weeks of treatment(P < 0.05),HDL-C increased significantly(P <0.05),DBP decreased,but there was no statistical difference(P> 0.05).4)Compared with before treatment,the FIB level,the platelet aggregation rate with arachidonic acid as the inducer,and the platelet aggregation rate with epinephrine as the inducer were significantly reduced after 8 weeks of treatment(P <0.05).There were no significant differences between PT,PT%,INR,APTT,TT,FDP,DD,platelet aggregation rate with collagen as the inducer,and platelet aggregation rate with adenosine diphosphate as the inducer before and after treatment(P> 0.05).5)Pearson correlation analysis showed that in the experimental group after 8 weeks of treatment,whether the platelet aggregation rate change value(? platelet aggregation rate(epinephrine))with epinephrine as the inducer or platelet aggregation with arachidonic acid as the inducer Rate change value(? platelet aggregation rate(arachidonic acid)),and BMI change value(?BMI),waist change value(? waist circumference),weight change value(? weight),cholesterol change value(?TCH),triglyceride Ester change value(?TG),low density lipoprotein change value(?LDL-C),high density lipoprotein change value(?HDL-C),fasting blood glucose change value(?FPG),glycated hemoglobin change value(?Hb A1c),fibrinogen There was no significant correlation between the change values(?FIB)(P> 0.05).Conclusions Platelet aggregation rate is significantly increased in patients with type 2diabetes.Exenatide can inhibit platelet aggregation rate with epinephrine and arachidonic acid as inducers in patients with type 2 diabetes,and this effect may be related to drug weight loss,It has nothing to do with the effect of reducing blood sugar and lipid.