利拉鲁肽对2型糖尿病合并骨量异常患者CA19—9、CA724、CEA及SF的影响

Effects of Liraglutide on CA19-9, CA724, CEA and SF in Type 2 Diabetic Patients with Bone Ab- normalities

【目的】探讨利拉鲁肽治对2型糖尿病合并骨量异常患者的糖类抗原19—9（CA199）、糖类抗原724（CA724）、癌胚抗原（CEA）及血清铁蛋白（SF）水平的影响。【方法】选择2015年12月至2017年3月本院内分泌科收治的诊断为2型糖尿病合并骨量异常的患者182例作为研究对象，随机分为观察组和对照组各91例。两组患者均给予饮食调节、运动调节干预，给予甘精胰岛素进行强化治疗。对照组患者根据血糖水平采用二甲双胍进行治疗；观察组患者采用利拉鲁肽进行治疗，并根据其血糖水平逐步减少甘精胰岛素剂量至停用胰岛素；两组患者均治疗至少3个月。对比两组患者治疗前后的空腹血糖（FPG）、2小时餐后血糖（2hPG）、糖化血红蛋白（HbA1c）及空腹胰岛素水平（FINS）水平，同时对比两组患者治疗前后的肿瘤标志物及SF水平变化情况。【结果】治疗前，两组患者FPG、2hPG、HbA1c、FINS水平比较，差异均无统计学意义（P〉0．05）；治疗后，两组患者的FPG、2hPG、HbA1c、FINS水平均显著降低，且观察组2hPG和FINs水平显著低于对照组，差异均具有统计学意义（P〈0．05）。治疗前，两组CA19-9、CA724、CEA及SF水平比较，差异无统计学意义（P〉0．05）；治疗后，两组各指标均显著降低，且观察组CA19-9、CA724、CEA及SF水平均显著低于对照组，差异具有统计学意义（P〈O．05）。【结论】利拉鲁肽能够有效降低2型糖尿病合并骨量异常患者的血糖水平、改善胰岛素敏感性，同时能显著降低患者的CA199、CA724、CEA及SF水平，并有可能减少患者糖尿病并发症和恶性肿瘤的发生风险。

[Objective] To investigate the effects of liraglutide on levels of CA19-9 （carbohydrate antigen 19 9）, CA724 （carbohydrate antigen 724）, CEA （carcinoembryonic antigen） and serum ferritin （SF） in patients with type 2 diabetes mellitus patients with abnormal bone mass.[Methods] A total of 182 patients with type 2 diabetes combined with bone abnormalities and who received treatment in the Department of Endocrinology in our hospital from December 2015 to March 2017 were randomly divided into the observation group and the control group, with 91 cases in each group. Patients of two groups of were given dietary adjustments, exercise intervention and insulin glargine intensive treatment. According to blood glucose levels, patients in the control group received metformin treatment and patients in the observation group received liraglutide treatment. Both groups were treated for at least 3 months. The fasting blood glucose （FPG）, 2 hour postprandial blood glucose （2hPG）, glycosylated hemoglobin （HbAlc） and fasting insulin （FINS） levels before and after treatment were compared between the two groups of patients. Meanwhile, the changes in tumor markers and SF levels before and after treatment were compared be- tween the two groups as well. [Results] Before treatment, there was no significant difference in FPG, 2hPG, HbAlc, and FINS levels between the two groups （ P 〉0.05）. After treatment, the FPG, 2hPG, HbAlc, and FINS levels in the two groups of patients were significantly lower. The levels of 2hPG and FINS in the observation group were significantly lower than those of the control group; the difference were with statistically significant （ P 〈0.05）. Levels of CA19 9, CA724, CEA and SF showed no significant differences before treatment （ P 〉0.05）. However, after treatment, they were significantly decreased in both groups. CA19-9, CA724, CEA and SF levels in the observation group after treatment were significantly lower than those of the control group. The differences were statistically significant （ P 〈0.05）. [Conclusion] Liraglutide can effectively reduce blood glucose levels and improve insulin sensitivity in patients with type 2 diabetes mellitus complicated with abnormal bone mass. It can significantly reduce the levels of CA19-9, CA724, CEA and SF as well. Thus, it may reduce the risk of diabetic complications and occurrence of malignant tumor.