利拉鲁肽治疗初诊腹型肥胖2型糖尿病患者的疗效观察

Observation of efficacy of Liraglutide in newly- diagnosed patients of abdominal obesity with type 2 diabetes

目的：观察利拉鲁肽治疗初诊腹型肥胖2型糖尿病患者的临床疗效。方法：选取2型糖尿病患者105例,按腰围分为A组、B组和C组。A组患者37例,男性21例,女性16例,腰围90.5~105.5 cm;B组患者35例,男性19例,女性16例,腰围105.5~120.5 cm;C组患者33例,男性16例,女性17例,腰围120.5~155.5 cm。3组患者均给予利拉鲁肽皮下注射,分别在24周、48周时测定腰围、体质指数（BMI）、空腹血糖（FPG）、餐后2 h血糖（2h PG）、糖化血红蛋白（Hb A1c）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL）、收缩压（SBP）、舒张压（DBP）,胰岛素抵抗指数（HOMA-IR）等指标。结果：1在治疗后24周、48周,3组患者的FPG、2h PG、Hb A1c、HOMA-IR、TG、LDL均较治疗前下降（P〈0.05）,其下降的幅度无统计学差异（P〉0.05）。2治疗24周,3组患者的SBP较治疗前下降,但无统计学意义（P〉0.05）,48周,较治疗前明显下降（P〈0.05）,但3组患者的SBP下降幅度无统计学差异（P〉0.05）;治疗后24周、48周,3组患者的DBP较治疗前均无明显下降（P〉0.05）。3治疗后24周、48周,3组患者的腰围、BMI均较治疗前下降（P〈0.05）;48周时对比,C组患者的腰围、BMI较A、B组下降幅度大（P〈0.05）;B组患者的腰围、BMI较A组下降幅度大（P〈0.05）。结论：利拉鲁肽不仅可明显降低患者空腹及餐后血糖、糖化血红蛋白,甘油三酯及低密度脂蛋白胆固醇水平,还能有效减轻胰岛素抵抗,降低收缩压、减轻体重、缩小腰围,同时腰围基线越大,腰围及体质指数下降程度越明显。

Objective To observe clinical efficacy of Liraglutide in newly-diagnosed patients of abdominal obesity with type 2diabetes. Methods： 105 cases of type 2 diabetes were enrolled and divided into three groups：37 cases of waistline 90. 5-105. 5cm （Agroup, 21 cases of male,16 cases of female）, 35 cases of waistline 105. 5-120. 5cm （B group,19 cases of male,16 cases of female）,33 cases of waistline 120. 5-155. 5cm （C group, 16 cases of male,17 cases of female）, All patients were given subcutaneous injectionof Liraglutide. The waistline,body mass index（BMI）,fasting plasma glucose（FPG）,2h postprandial plasma glucose （2hPG）, glycosylated hemoglobin A1c （HbA1c）,triglyceride（TG）,low density lipoprotein cholesterol （LDL）,systolic blood pressure （SBP）,diastolicblood pressure （DBP）, HOMA-IR of each patient were measured before and 24,48 weeks after the treatment. Results： （1）24 and 48weeks after the treatment,the levels of FPG, 2hPG,HbA1c, HOMA-IR, TG, and LDL were decreased in the three groups comparedwith those before the treatment （P〈0. 05）; however, the decreased degree in the above all indexes was not statistically different in thethree groups （P〉0. 05）. （2） 24 weeks after the treatment,the levels of SBP was decreased in three groups compared with those beforethe treatment,but there were no statistically differences （P〉0. 05）. 48 weeks after the treatment,the levels of SBP was obviously decreased in three groups compared with those before the treatment（P〈0. 05）,but the decreased degrees in SBP were not statistically different in the three groups （P〉0. 05）. The levels of DBP had no obvious decline 24 and 48 weeks after the treatment in the three groupscompared with those before the treatment （P〉0. 05）. （3） The levels of waistline and BMI were decreased 24 and 48 weeks after thetreatment in the three groups compared with those before the treatment（P〈0. 05）, and the decreased degrees in the waistline and BMIin C group was the largest, followed by B group and A group, orderly（P〈0. 05）. Conclusions： Liraglutide not only canobviously reduce the levels of FPG,2hPGC,HbA1c,triglyceride, and LDL, but also can effectively reduce HOMA-IR, SBP and waistline. Thegreater waistline baseline is,the more in the extent of the waistline and BMI decrease.