GLP-1受体激动剂对2型糖尿病患者短期与长期代谢控制的影响

Investigate the effect of the GLP-1 receptor agonist on patients with type 2 diabetes mellitus(T2DM) between the short-term and long-term metabolic control

目的探讨GLP-1受体激动剂对2型糖尿病(T2DM)患者短期与长期代谢控制的影响。方法选取2010~2013年于青岛市内分泌糖尿病医院应用艾塞那肽治疗的120例T2DM患者,根据使用时间分两组:使用时间≤24周(A组,n=58),使用时间>24周(B组,n=62)。分别记录治疗前后体重、WC、HC、FBG、P2hBG、HbA1C、TG、TC、LDL、HDL、SBP、DBP,并计算BMI、WSR、WHR,均行骨密度检查,测定全身脂肪含量。结果 A、B两组体重、BMI、全身脂肪含量均较治疗前下降,但组间差异无统计学意义(P>0.05);A、B两组WC、WSR、FBG、P2hBG、HbA1C、SBP、DBP均较治疗前下降,组间比较差异有统计学意义(P<0.05)。两组TG、TC、LDL、HDL较治疗前后及组间差异无统计学意义(P>0.05)。两组胃肠道不良反应及低血糖发生率组间差异无统计学意义(P>0.05)。结论长期应用GLP-1受体激动剂治疗2型糖尿病临床疗效较好,不增加胃肠道及低血糖反应发生风险,使体脂重新分布,改善腹型肥胖及胰岛素抵抗。

Objective To Investigate the effect of the GLP-1 receptor agonist on patients with type 2 diabetes mellitus (T2DM) between the short-term and long-term metabolic control. Methods 120 patients with T2DM treated with Exenatide in Qingdao Endocrinology Diabetes Hospital from 2010 to 2013 were divided into two groups due to the term of drug use. Patients in group A (n=58) applied Exenatide not less than 24 weeks,while those in goup B (n=62) more than 24 weeks. Indicates included body weight (before and after the treatment), WC, HC, FBG, P2Hbg, HbA1C, TG, TC, LDL, HDL, SBP, DBP, BMI, WSR, WHR, BMD, and body fat content. Results The body weight, BMI and the body fat content in two groups were both decreased than that before treatment, which had no significant difference in the comparison between groups (P>0.05); WC, WSR, FBG, P2hBG, HbA1C, SBP, DBP in two groups were both decreased than that before treatment, which had statistically significant difference in the comparison between the two groups (P < 0.05).TG, TC, LDL, HDL in two groups had no statistically different neither before nor after treatment (P > 0.05). Neither the gastrointestinal adverse reaction nor the rate of hypoglycemia in the two groups had no statistically different in the comparison between groups (P>0.05). Conclusion The better clinical effect of GLP-1 receptor agonists for T2DM lies in long-term application, which can also decrease the risk of the gastrointestinal reactions and hypoglycemia, redistribute the body fat and improve abdominal obesity and insulin resistance.