艾塞那肽对肥胖2型糖尿病患者血清成纤维细胞生长因子21的影响

Effect of Exenatide on serum fibroblast growth factor 21 levels in obese patients with type 2 diabetes mellitus

目的探讨艾塞那肽对肥胖T2DM患者血清成纤维细胞生长因子21(FGF-21)的影响。方法选取单用二甲双胍或磺脲类控制不佳的肥胖T2DM患者43例(EX组),同时选取同年龄段糖脂代谢正常者45名作为健康对照(NC)组,单纯T2DM患者45例作为对照组(T2DM组)。EX组在原口服降糖药治疗基础上,用艾塞那肽治疗16周,观察治疗前后体重、BMI、WC、臀围、WHR、FPG、HbA1c、FIns、HOMA-IR、HOMA-β、血脂及血清FGF-21等指标,分析艾塞那肽治疗对EX组血清FGF-21的影响,并对FGF-21与上述代谢指标进行相关性分析。结果与治疗前比较,EX组加用艾塞那肽16周后血清FGF-21水平降低(t=2.400,P<0.05),且与HOMA-IR的降低呈正相关(β=0.461,P<0.01)。结论艾塞那肽可降低肥胖T2DM患者血清FGF-21水平,可能与IR的改善密切相关。

Objective To explore the effect of Exenatide on serum fibroblast growth factor 21（FGF-21）levels in obese patients with type 2 diabetes mellitus（T2 DM）. Methods Obese patients with T2DM treated with Metformin or Sulfonylurea drugs for at least 3 months and with unsatisfactory glycemic control were selected in this study as EX group（n=43）.Age matched healthy controls with normal blood glucose and blood lipid levels were selected as NC group（n=45）.Patients with T2DM were selected as T2 DM group（n=45）.EX group was treated with Exenatide as an additional therapy for 16 weeks.Weight,body mass index（BMI）,waist circumference（WC）,hip circumference,waist hip ratio（WHR）,fasting plasma glucose（FPG）,glycosuria hemoglobin（HbA1 c）,fasting insulin（FIns）,homeostasis model assessment of insulin resistance（HOMA-IR）,homa-beta cell function index（HOMA-β）,blood lipid and serum FGF-21 were measured in EX group at baseline and after treatment.The influence of Exenatide treatment on FGF-21 was evaluated.The correlations of FGF-21 levels with above indices were analyzed. Results After 16 weeks of Exenatide treatment,serum FGF-21 levels were significant decreased in EX group（t=2.400,P〈0.05）.The decline of FGF-21 was positively associated with the decrease of HOMA-IR（β=0.461,P〈0.01）. Conclusion Exenatide can decrease the level of serum FGF-21,and may correlated with improved IR in obese patients with T2DM.