艾塞那肽治疗不同体重指数的2型糖尿病患者的效果及安全性分析

Analysis on efficacy and safety of Exenatide in the treatment of type 2 diabetes patients with different body mass index

目的研究艾塞那肽治疗不同体重指数(BMI)2型糖尿病患者的效果及安全性。方法选取海南省人民医院2011年11月～2012年10月经口服降糖药治疗而血糖控制不佳的2型糖尿病患者64例,按BMI分为两组:A组(19 kg/m2≤BMI<24 kg/m2)31例,B组(BMI≥24 kg/m2)33例。给予艾塞那肽治疗16周后对比两组患者治疗前后的空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、体重、BMI、收缩压(SBP)、舒张压(DBP)变化及药物不良反应。结果 61例患者完成16周试验,3例患者因消化道反应退出试验。两组患者的FPG、2 h PG、HbA1c、TG、体重、BMI均较治疗前显著降低(P<0.01),HOMA-β、HDL-C较治疗前升高(P<0.05)。两组间比较,B组的体重、BMI降幅显著大于A组(P<0.01)。轻中度消化道反应发生率为42.6%,低血糖发生率为14.8%,无严重低血糖。结论艾塞那肽适用于血糖控制欠佳的不同体重指数的2型糖尿病患者,超重或肥胖患者体重降低更显著。

Objective To compare efficacy and safety of Exenatide in type 2 diabetes patients with different body mass index （BMI）. Methods 64 patients with type 2 diabetes treated with oral antidiabetic drugs and with inadequately glucose controlled in Hainan Provincial People＇s Hospital from November 2011 to October 2012 were enrolled. These patients were selected and randomized into two groups by BMI, there were 31 patients in group A （19 kg/m^2≤BMI〈24 kg/m^2）, 33 patients in group B （BMI≥24 kg/m^2）. The patients received Exenatide for 16 weeks, before the observation and in the end of the observation, fasting plasma glucose （FPG）, postprandial glucose （2 h PG）, glycosylated hemoglobin （HbA1c）, HOMA-IR, HOMA-β, weight, body mass index （BMI）, systolic blood pressure （SBP）, diatolic blood pressure （DBP）, lip profiles （TC, TC, HDL-C, LDL-C） and side effects were evaluated. Results 61 patients accomplished the study, 3 patients retreated the study owing to the gastrointestinal reactions. In both groups, FPG, 2 h PG, HbA1c, TG, weight and BMI were all significantly decreased （P 〈 0.01）, HOMA-~, HDL were all significantly increased （P 〈 0.05）. Between the two groups, weight and BMI decreased greater in group A than that in group B （P 〈 0.01）. The incidence of mild to moderate gastrointestinal reactions and hypoglycemic were 42.6%, 14.8%, respectively. Conclusion Treatment of Exenatide is efficient and safe in type 2 diabetes patients with different BMI. There is a greater reduction in the weight loss in the overweight or obese patients.