肠促胰腺素类降糖药物对2型糖尿病患者骨质代谢的影响

Effect of Incretin-Like Hypoglycemic Drugs on Bone Metabolism in Patients with Type 2 Diabetes Mellitus

目的探讨肠促胰腺素类降糖药物对2型糖尿病患者骨质代谢的影响。方法回顾性分析医院101例2型糖尿病患者的临床资料,根据其治疗方案的不同进行分组,其中行二甲双胍+二肽基肽酶4(DPP-4)抑制剂(西格列汀片)治疗的为A组(34例),进行二甲双胍+胰高血糖素样肽-1(GLP-1)受体激动剂治疗的为B组(31例),进行二甲双胍+甘精胰岛素治疗的为C组(36例)。结果 3组患者治疗前的性别、年龄、糖尿病病程、体质量指数(BMI)、糖化血红蛋白(HbA1C)、空腹血糖(FBG)比较均无显著差异(P>0.05);治疗后,A组体质量明显大于B组与C组(P<0.05),骨密度(BMD)、血清钙离子(Ca^(2+))浓度、磷酸盐和碱性磷酸酶(ALP)水平均明显高于B组与C组(P<0.05);B组BMD、血清Ca^(2+)、磷酸盐和ALP水平与C组比较均无显著性差异(P>0.05)。结论 DPP-4抑制剂与二甲双胍联合治疗2型糖尿病疗效显著,且对BMD和血清骨代谢标志物水平有更好的改善作用。

Objective To investigate the effect of incretin-like hypoglycemic drugs on bone metabolism in patients with type 2 diabetes mellitus（ T2DM）.Methods The clinical data of 101 patients with T2DM in our hospital were retrospectively analyzed.The patients were divided into 3 groups according to their treatment regimens：Group A（ 34 cases） was treated with metformin and DPP-4 inhibitor（ Sitagliptin Tablets）,group B（ 31 cases） was treated with metformin and GLP-1 receptor agonist,group C（ 36 cases） was treated with metformin and insulin glargine.Results There was no significant difference in the gender,age,duration of diabetes,BMI,HbA1 Cand FBG among the three groups before treatment（ P〈0.05）.After treatment,the body weight in group A was significantly higher than those in group B and group C（ P〉0.05）.After treatment,the levels of bone mineral density（ BMD）,serum Ca2＋ concentration,phosphate and alkaline phosphatase in group A were significantly higher than those group B and group C（ P〈0.05）,but there was no significant difference in the above indexes between group B and group C（ P〈0.05）.Conclusion DPP-4 inhibitor combined with metformin is effective in the treatment of T2DM,and it has a good improvement effect on the BMD and serum bone metabolism markers.