Effects of liraglutide combined with metformin on glucose and lipid metabolism, islet beta cell function and body fat in obesity with type 2 diabetes mellitus

Abstract

Objective To investigate the effects of liraglutide combined with metformin on glucose and lipid metabolism, islet beta cell function and body fat in obesity patients with type 2 diabetes mellitus. Methods 141 obesity patients with type 2 diabetes mellitus admitted to our hospital from January 2017 to December 2018 were enrolled. According to the random number table, 47 cases were randomized into the liraglutide group, 47 cases in the metformin group and 47 cases in the combination group. The three groups were treated with liraglutide, metformin, and the combination of liraglutide and metformin respectively. The course of treatment was 3 months in all three groups. The changes of glucose metabolism, lipid metabolism, islet beta cell function and body mass index (BMI) and adverse reactions were compared among the three groups. Paired-samples t test was used for the comparison of difference before and after treatment, One-way ANOVA for comparison between the three groups, and LSD-t test for multiple comparison. Results After treatment, the levels of FPG, HbA1c and 2hPG in the three groups were lower than those before treatment (P < 0.05) . After treatment, FPG (6.57±0.39) mmol/L, HbA1c (7.03±0.42) % and 2hPG (8.78±0.45) mmol/ L in the combined group were lower than those in the liraglutide group (7.03±0.32) mmol/L, (7.68±0.35) %, (9.56±0.65) mmol/L (t = 6.251, 8.151, 6.764, P < 0.05) and metformin group (7.06±0.39) mmol/L, (7.76±0.46) %, (9.70±0.81) mmol/L (t = 6.091, 8.034, 6.807, P < 0.05) . The levels of HDL-C increased after treatment, while the levels of TC, LDL-C and TG decreased after treatment (P < 0.05) . After treatment, HDL-C (1.56±0.13) mmol/L in the combination group was higher than that in the liraglutide group (1.29±0.14) mmol/L (t = 9.689, P < 0.05) and the metformin group (1.32±0.15) mmol/L (t = 8.289, P < 0.05) ; However, the combination group' TC (4.35±0.38) mmol/L, LDL-C (2.79±0.21) mmol/L and TG (2.15±0.26) mmol/L were lower than those in the liraglutide group (5.18±0.43) mmol/L, (3.19±0.15) mmol/L, (2.65±0.17) mmol/ L (t = 9.916, 10.626, 11.035, P < 0.05) and the metformin group, (5.15±0.34) mmol/L, (3.23±0.25) mmol/L, (2.68±0.23) mmol/ L (t = 10.756, 9.239, 10.467, P < 0.05) . HOMA-β in the three groups increased after treatment (P < 0.05) . HOMA-β in the combination group was higher than that in the liraglutide group (4.15±0.36) (t = 10.823, P < 0.05) and the metformin group (4.08±0.41) (t = 10.909, P < 0.05) . BMI in the three groups decreased after treatment (P < 0.05) . The combination group BMI (28.08±0.37) kg/m2 was lower than that in the liraglutide group (29.73±0.49) kg/m2 (t = 18.423, P < 0.05) and the metformin group (29.61±0.43) kg/m2 (t = 18.490, P < 0.05) . Conclusion Liraglutide combined with metformin has a good effect on obesity patients with type 2 diabetes mellitus. It can improve glucose and lipid metabolism, pancreatic beta cell function and reduce body mass index. Key words: Liraglutide; Metformin; Obesity; Type 2 diabetes mellitus; Glycolipid metabolism; Islet β cell function; Body fat