利拉鲁肽联合基础胰岛素对初诊2型糖尿病合并肥胖患者血糖控制、血脂代谢及氧化应激的影响

Effect of liraglutide combined with basal insulin on blood glucose control,lipid metabolism and oxidative stress in patients with newly diagnosed type 2 diabetes mellitus complicated by obesity

目的:探讨利拉鲁肽联合基础胰岛素对初诊2型糖尿病合并肥胖患者血糖控制、血脂代谢及氧化应激的影响。方法:选择2017年2月~2017年8月间在西安市第四医院确诊并接受治疗的初诊2型糖尿病合并肥胖患者58例,经随机数表法分为接受基础胰岛素治疗的对照组、接受利拉鲁肽联合基础胰岛素治疗的利拉鲁肽组,各29例,对比两组患者治疗前后糖脂代谢指标水平、氧化应激指标含量的差异。结果:治疗前,两组患者外周血中糖脂代谢指标水平、血清中氧化应激指标含量的差异无统计学意义(P>0.05)。治疗1个月后,利拉鲁肽组外周血中糖代谢指标空腹血糖(FBG)、胰岛素抵抗指数(HOMA-IR)的水平较对照组低(P<0.05);外周血中脂质代谢指标总胆固醇(TC)、甘油三酯(TG)、载脂蛋白B(ApoB)的水平较对照组低(P<0.05),载脂蛋白A1(ApoA1)的水平较对照组高(P<0.05);血清中氧化指标丙二醛(MDA)、脂质过氧化氢(LHP)的含量较对照组低(P<0.05),抗氧化指标谷胱甘肽过氧化物酶(GSH-Px)、总抗氧化能力(T-AOC)的含量较对照组高(P<0.05)。结论:初诊2型糖尿病合并肥胖患者在基础胰岛素治疗基础上加入利拉鲁肽联合治疗,可进一步控制机体糖脂代谢水平并抑制全身氧化应激反应。

Objective:To investigate the effect of liraglutide combined with basal insulin on blood glucose control,lipid metabolism and oxidative stress in patients with newly diagnosed type 2 diabetes mellitus complicated by obesity.Methods:A total of 58 patients with newly diagnosed type 2 diabetes mellitus complicated by obesity who were diagnosed and treated in Xi'an No.4 Hospital between February 2017 and August 2017 were divided into the control group(n=29)who received basal insulin therapy and the liraglutide group(n=29)who received liraglutide combined with basal insulin therapy according to random number table.The differences in the levels of glycolipid metabolism indexes and the contents of oxidative stress indexes were compared between the two groups before and after treatment.Results:Before treatment,the differences in the levels of glycolipid metabolism indexes in peripheral blood and the contents of oxidative stress indexes in serum were not statistically significant between the two groups(P>0.05).After 1 month of treatment,glucose metabolism indexes FBG and HOMA-IR levels in peripheral blood of liraglutide group were lower than those of control group;lipid metabolism indexes TC,TG,ApoB levels in peripheral blood were lower than those of control group,ApoA1 level were higher than those of control group;serum oxidation indexes MDA and LHP contents were lower than those of control group whereas anti-oxidation indexes GSH-Px and T-AOC contents were higher than those of control group.Conclusion:Liraglutide combined with basal insulin therapy can further control the glucolipid metabolism levels and inhibit the systemic oxidative stress response in patients with newly diagnosed type 2 diabetes mellitus complicated by obesity.