| Objective:To evaluate systematically the effect of Liraglutide on insulin resistance in overweight or obese patients with type 2 diabetes mellitus(T2DM).Method:In this research,search terms such as "Liraglutide","type 2 diabetes mellitus","T2DM","Insulin resistance" were searched on official websites such as Pubmed,Cochrane Library,EMBASE,EBSCO and CNKI.The deadline for searching literature was June 2018.According to the criteria of inclusion and exclusion,the relevant literatures were screened out,the full text was carefully read to obtain the relevant data,and then the Meta-analysis was carried out with Review Manager 5.3software.According to the purpose of this study,the method of liraglutide intervention was regarded as the experimental group;other methods of intervention,including placebo,were regarded as the control group.The observation indexes were: HbA1 c,fasting insulin,FPG,body weight and body mass index(BMI),HOMA IR,systolic and diastolic blood pressure,serum total cholesterol(TC)and serum low-density lipoprotein cholesterol(LDL-C).Results:Finally,14 RCTs were included,totaling 3951 patients.Each of the above observations is input into the Review Manager 5.3 software,and the data are merged and analyzed to obtain the results.The results showed that the effect of liraglutide group on reducing HbA1 c was better than that of control group(WMD=-0.82,95%CI [-1.22,-0.41],P < 0.0001);There was no significant difference in fasting insulin regulation between the two groups(WMD=0.63,95%CI [-0.67,1.92],P=0.34);The effect of liraglutide group on reducing FPG was better than that of control group(WMD=-1.04,95%CI [-1.60,-0.48],P=0.0003);The effect of liraglutide group on reducing HOMA IR was better than that of control group(WMD=-0.67,95%CI [-1.29,-0.05],P=0.03);The effect of liraglutide on weight loss was better than that of control group(WMD =-3.13,95%CI [-3.48,-2.78],P<0.00001);The effect of liraglutide on reducing BMI was better than that of control group(WMD=-0.94,95%CI [-1.72,-0.16],P=0.02);The effect of total cholesterol in liraglutide group was better than that in control group(WMD=-0.14,95%CI [-0.24,-0.05],P=0.003);The effect of liraglutide group on lowering LDL cholesterol was better than that of control group(WMD=-0.12,95%CI[-0.19,-0.05],P=0.0005);The effect of liraglutide group on reducing SBP was betterthan that of control group(WMD=-4.27,95%CI [-6.47,-2.06],P=0.0001);There was no significant difference in DBP between the two groups(WMD=-0.51,95%CI [-2.24,1.23],P=0.57).Conclusions:Liraglutide is superior to the control group in reducing blood sugar,reducing body weight,reducing BMI and improving insulin resistance in overweight or obese type 2 diabetic patients.Liraglutide also showed significant efficacy in other diabetes-related risk factors such as hypertension and hyperlipidemia.Therefore,liraglutide provides a new choice of hypoglycemic agents for type 2 diabetic patients,especially those who are overweight or obese. |
