利拉鲁肽单药治疗早发初诊2型糖尿病患者疗效观察

Clinical effects of liraglutide monotherapy in the treatment of newly diagnosed patients with early-onset type 2 diabetes

比较利拉鲁肽单药治疗早发初诊2型糖尿病（T2DM）肥胖与非肥胖患者的临床疗效.选取年龄18 ～40岁的早发T2DM肥胖患者63例（男41例,女22例）,非肥胖患者37例（男24例,女13例）.予利拉鲁肽1.2mg每日单药治疗,分别于2、6、12周随访,比较用药前后血糖、血脂各指标变化.两样本间比较采用独立样本t检验.结果发现,（1）与基线值相比,治疗12周后,肥胖组体重由（89±13）下降至（84±12） kg,非肥胖组体重由（66±9）下降至（64 ±8） kg;肥胖组空腹血糖（FPG）由（10.3±1.8）下降至（6.6±0.8）mmol/L,非肥胖组FPG由（10.1±1.9）下降至（7.7±0.8）mmol/L.（2）肥胖组餐后2h血糖（2 h PG）、糖化血红蛋白（HbA1c）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）下降,空腹胰岛素（FINS）、空腹C肽（FCP）升高,差异有统计学意义（t=-2.093～7.810,均P＜0.05）.非肥胖组也好转,但TC、LDL-C、高密度脂蛋白胆固醇（HDL-C）差异无统计学意义（t=1.315 ～1.870,均P＞0.05）.（3）与基线时相比,Ⅱ度肥胖组利拉鲁肽单药治疗后体重、2 hPG、HbA1c改善更明显[分别为（92±13）比（98±14） kg、（8.2±1.9）比（15.0±2.6） mmol/L、（6.4±1.0）％比（9.5±1.2）％],差异有统计学意义（t=3.079、7.886、5.081,均P ＜0.05）.其余指标均有一定程度改善,但差异无统计学意义.提示利拉鲁肽单药治疗早发初诊T2DM肥胖组患者可明显改善体重、血糖、血脂、胰岛功能,且初诊肥胖程度重的患者疗效更好.

To observe the clinical effects of liraglutide monotherapy in the treatment of obese or non-obese newly diagnosed patients with early-onset type 2 diabetes mellitus （T2DM）.In this study,63 obese patients and 37 non-obese patients with early-onset T2DM were chosen to be treated with 1.2 mg liraglutide monotherapy for 12 weeks.Follow-up interviews were conducted at three stages respectively in 2,6 and 12 week.Comparisons were made between the index changes in each patient before and after the treatment using independent samples t test.The results showed that：（1） After 12 weeks of treatment,comparing with the baseline levels,the body weight of group of obese patients decreased （from （89 ± 13） kg to （84 ± 12） kg,and group of non obese patients decreased from （66 ± 9） kg to （64 ± 8） kg） ; The fasting plasma glucose （FBG） of group of obese patients decreased from （10.3 ± 1.8） mmol/L to （6.6 ± 0.8） mmol/L,and which in group of non-obese patients decreased from （10.1 ± 1.9） to （7.7 ±0.8） mmol/L.（2）The level of 2-hour plasma glucose （2 h PG）,glycosylated hemoglobin A1c （HbA1c）,total cholesterol （TC）,triglyceride （TG）,low-density lipoprotein-cholesterol （LDL-C） decreased,fasting insulin （FINS）,fasting C peptide（FCP） group of obese patients increased（t =-2.093-7.810,all P 〈 0.05）.The non-obese group patients TC,LDL-C,HDL-C also improved,but the differences were not statistically significant （t =1.315 -1.870,P 〈 0.05）.（3） After 12 weeks of treatment,comparing with the baseline levels,group of severe obesity patients apparently improved on body weights,2 h PG,HbA1 c （（92 ± 13）to （98 ± 14） kg,（8.2 ± 1.9）to （15.0 ±2.6） mmol/L,（6.4±1.0）% to（9.5 ±1.2）%,t =3.079,7.886,5.081,all P〈 0.05）.The other indexes were improved to some extent,but the differences were not statistically significant.That means liraglutide monotherapy has obvious improvement on body weight,plasma glucose level and islet β cell function in newly diagnosed obese patients with early-onset T2DM,especially in severe obesity patients.