长期应用利拉鲁肽对首诊2型糖尿病肥胖患者体质量、腰臀比和心血管风险的影响

Influence of long-term application of liraglutide on body mass,waist-hip ratio and cardiovascular risk in obese patients with type 2 diabetes mellitus diagnosed for the first time

目的:探讨长期应用利拉鲁肽对首诊2型糖尿病肥胖患者体质量、腰臀比和心血管风险的影响。方法:选取2018年1月~2019年12月在我院接受治疗的126例首诊2型糖尿病肥胖患者为研究对象,采用随机数字表法随机分为对照组和观察组,每组各63例。对照组患者采用二甲双胍治疗,观察组在对照组的基础上加用利拉鲁肽治疗,连续治疗6个月。比较两组患者血糖水平包括空腹血糖(FBG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c),血脂水平包括三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C),比较两组患者体重指数、腰臀比及心血管风险因子左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、舒张早期最大峰值速度/舒张晚期最大峰值速度(E/A)、颈动脉中层内膜厚度(IMT)、血清同型半胱氨酸(Hcy)及N端前脑钠肽(NT-proBNP)水平。结果:治疗后观察组患者FBG、2hPG、HbA1c、TC、TC、LDL-C、体重指数、腰臀比、LVEDD、IMT、Hcy及NT-proBNP水平均较对照组低,HDL-C、LVEF及E/A水平均较对照组高,差异具有统计学意义。结论:长期应用利拉鲁肽联合二甲双胍治疗能够有效降低2型糖尿病肥胖患者血糖、血脂、体质量和腰臀比,改善心功能,减少心血管风险。

Objective To investigate the effect of long-term application of liraglutide on body mass,waist-hip ratio and cardiovascular risk in obese patients with type 2 diabetes mellitus diagnosed for the first time.Methods 126 obese patients with type 2 diabetes who were first diagnosed in our hospital from March 2016 to June 2017 were selected as the study subjects.Random number table method was used to randomly divide the patients into control group and observation group,and 63 cases in each group.The control group was treated with metformin,while the observation group was treated with liraglutide on the basis of the control group.Continuous treatment for 6 months.The blood glucose level including fasting blood glucose(FBG),postprandial 2H blood glucose(2hPG),and glycosylated hemoglobin(HbA1c),blood lipid level including triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL-C),and high density lipoprotein(HDL-C),body mass index,waist-hip ratio and the level of cardiovascular risk factors including left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),Maximum peak velocity in early diastole/peak velocity in late diastole(E/A),carotid intima-media thickness(IMT),serum homocysteine(Hcy)and N-terminal pro-brain natriuretic peptide(NT-proBNP)were compared between the two groups.Results After treatment,the level of FBG,2hPG,HbA1c,TC,TC,LDL-C,BMI,waist-hip ratio,LVEDD,IMT,Hcy and NT-proBNP in the observation group were lower than those in the control group,while the level of HDL-C,LVEF and E/A in the observation group were higher than those in the control group,with significant differences.Conclusion Long-term application of liraglutide combined with metformin can effectively reduce blood sugar,lipid,body mass and waist-hip ratio,improve cardiac function and reduce cardiovascular risk in obese patients with type 2 diabetes mellitus.