GLP-1类似物与DPP-4抑制剂对肥胖2型糖尿病患者疗效观察

Efficacy of liraglutide GLP- 1 analogues combined with DPP- 4 inhibitor in obese patients with type 2 diabetes

目的:比较GLP-1类似物与DPP-4抑制剂对肥胖2型糖尿病患者血糖、血脂的影响。方法:选取就诊的体型肥胖且在服用二甲双胍后血糖控制仍不理想2型糖尿病患者36例,随机分为DPP-4抑制剂西格列汀组和GLP-1类似物利拉鲁肽组,每组各18例。西格列汀组加予磷酸西格列汀片,利拉鲁肽组加予利拉鲁肽注射液治疗,治疗时间12周。观察治疗前后空腹血糖(FBG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、BMI以及相关不良反应。结果:两组的FBG、餐后2h PG、HbA1c治疗前后对比,差异有统计学意义(P<0.05);利拉鲁肽组治疗前后相比TC、TG、HDL-C和LDL-C、BMI均具有统计学意义(P<0.05)。而西格列汀组TC及BMI治疗前后相比,差异有统计学意义(P<0.05),TG、HDLC和LDL-C治疗前后相比,差异无统计学意义(P>0.05)。结论:GLP-1类似物利拉鲁肽组与DPP-4抑制剂西格列汀均能改善肥胖2型糖尿病患者血糖、总胆固醇、及体质量,且利拉鲁肽的效果可能优于西格列汀。利拉鲁肽对三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇亦有改善作用,而西格列汀不明显。

Objective Comparison of GLP- 1 analogues and DPP- 4 inhibitors on blood glucose and blood lipids,from the obese patients with type 2 diabetes. Method 36 obese patients with type 2 diabetes who took metformin invalid were selected. They were randomly divided into 2 groups： sitagliptin group and liraglutide group. Each group contained 18 people. On the basis of the original treatment,one group was treated with sitagliptin,another group was injected with liraglutide. The treatment lasted 12 weeks. The changes of FBG,2h PG,HbA1c,TC,TG,HDL- C,LDL- C and BMI in the beginning and the end time of this treatment were compared. Results The FBG、2h PG、HbA1c between the two groups were compared,there were significant differences between them（ P〈0. 05）. The TC、TG、HDL- C、LDL- C、BMI before and after in the liraglutide group were compared,there were significantly different（ P〈0. 05）. In sitagliptin group,TC and BMI before and after were compared,there were significantly different（ P〈0. 05）,but TG、HDL- C、LDL- C did not statistical difference（ P〉0. 05）. Conclusion GLP- 1 analogues and DPP- 4 inhibitor can ameliorate blood glucose,blood lipids and BMI on obese type 2 diabetes. The effect of liraglutide may be better than sitagliptin. Liraglutide also can ameliorate triglycerides,HDL- C,LDL- C,but the effect of sitagliptin is not obvious.