利拉鲁肽治疗2型糖尿病合并肥胖疗效观察

Efficacy of Liraglutide in Type 2 Diabetes Patients Complicated with Obesity

目的:观察利拉鲁肽治疗2型糖尿病(T2DM)合并肥胖患者的降糖及减重作用,探讨合并肥胖的T2DM新的治疗思路。方法:超重和肥胖的T2DM患者38例,入组前口服降糖药物或应用胰岛素治疗血糖控制不达标,按体质指数(BMI)分为两组,A组为超重组(BMI 24~28 kg·m^(-2))18例、B组为肥胖组(BMI≥28 kg·m^(-2))20例,两组均加用利拉鲁肽治疗12周,观察治疗前后两组患者身高、体质量和BMI;2 h空腹和餐后2 h血糖(FPG,2h PG)、糖化血红蛋白(Hb A1c),空腹(FINS)和餐后2 h胰岛素(2h INS)、空腹(FCP)和餐后2 h C肽(2h CP);以及胰岛素抵抗指数(HOMA-IR)和胰岛β细胞分泌功能指数(HOMA-β)。结果:治疗后两组患者的Hb A1c、FBG、2h PG、FCP、2h CP及HOMA-β、HOMA-IR等指标均较治疗前明显改善(P<0.01);两组上述指标组间比较无明显差异(P>0.05)。治疗后B组患者体质量和BMI较治疗前下降明显(P<0.01),而A组体质量和BMI无明显改变(P>0.05)。结论:超重和肥胖T2DM患者,加用利拉鲁肽治疗后,可有效地控制血糖,改善胰岛素抵抗,而肥胖患者体质量较治疗前有明显下降。

Objective： To observe the hypoglycemic and weight loss effects of liraglutide in type 2 diabetes mellitus （T2DM） complicated with obesity, and explore new treatment strategies for T2DM complicated with obesity. Methods： Totally 38 T2DM patients complicated with obesity with dissatisfactory blood sugar control treated with oral hypoglycemic drugs or insulin were enrolled and divid- ed into group A （overweight group, 28 kg·m^-2 〉 BMI≥24 kg·m^-2, 18 cases） and group B （obesity group, BMI≥28 kg·m^-2, 20 cases） according to the body mass index （BMI）. Liraglutide was used in all the participants for 12 weeks. The height, weight, BMI, HbA1 c, fasting blood glucose （ FBG）, 2-hour postprandial blood glucose （ 2hPG）, fasting insulin （FINS）, 2 -hour postprandial in- sulin （2hPINS）, fast-c peptide （FCP）, 2-hour postprandial c-peptide （2hCP） and insulin resistance index （HOMA-IR）, pancreatic [5 cell function index（HOMA-β） of the two groups were detected before and after the liraglutide treatment. Results： After the treatment with liraglutide, HbAlc, FPG, 2hPG, FCP,2hCP, HOMA-β, HOMA-IR were significantly decreased （ P 〈 0.01 ） than before in the two groups, while there were no significant differences between the groups（P 〉0.05）. However, the body weight in group B was sig- nificantly lower than before （P 〈 0.01 ）, while there were no significant change in group A （P 〉 0.05 ）. Conclusion： Liraglutide can effectively control blood glucose level, ameliorate insulin resistance and obviously decrease the body weight in the T2DM patients com- plicated with obesity.