利拉鲁肽对老年2型糖尿病患者糖脂代谢胰岛功能及骨密度的影响

The effects of liruglutide on insulin function und bone mineral density in elderly patients with type 2 diabetes mellitus

目的观察利拉鲁肽对老年2型糖尿病患者糖脂代谢、胰岛功能及骨密度的影响.方法60例老年2型糖尿病患者随机分为利拉鲁肽组及二甲双胍组,每组各30例,在治疗前及治疗4周后检测血糖、血脂、胰岛功能、骨密度等相关指标.结果治疗前两组各项指标差异无统计学意义(P>0.05).与治疗前比较,两组患者治疗4周后空腹血糖(FBG)、餐后2h血糖(2h-PG)、糖化血红蛋白(HbA1c)水平显著下降(P<0.05),两组间无明显差异(P>0.05).两组患者胰岛素治疗后总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS)、空腹C肽(FC-P)、胰岛素抵抗指数(HOMA-IR)明显下降,高密度脂蛋白胆固醇(HDL-C)、胰岛素分泌指数(HOMA-β)明显升高,且利拉鲁肽组对糖脂代谢、胰岛功能相关指标的改善幅度较二甲双胍更为显著,差异具有统计学意义(P<0.05).利拉鲁肽治疗后较治疗前能显著改善骨密度(BMD)和骨钙素(BGP)(P<0.05),而二甲双胍对此无影响.结论对于老年2型糖尿病患者,使用利拉鲁肽能够有效控制血糖,调节脂代谢,减轻胰岛素抵抗,改善胰岛功能,改善骨密度状态.

Objective To observe the effects of Liraglutide on glycolipid metabolism,islet function and bone mineral density in elderly patients with type 2 diabetes mellitus.Methods 60 elderly patients with type 2 diabetes were randomly divided into Liraglutide group and Metformin group,with 30 patients in each group.Blood glucose,blood lipids,islet function and bone mineral density were measured before and after 4 weeks of treatment.Results There were no differences between the two groups before treatment.Compared with the baseline,FPG,2h-PG,HbAlc were decreased significantly in the two groups(P<0.05)and there was no obvious change between the two groups(P>0.05).The TC,TG,LDL-C,fasting insulin(FINS),fasting C-peptide(FC-P),insulin resistant index(HOMA-IR)were decreased in the two groups,and more evidently in the Liraglutide group(P<0.05).The HDL-Cand insulin secretion index(HOMA-IR) were significantly increased in the two groups,and more evidently in the Liraglutide group(P<0.05).The BMD and BGP were significantly improved after the treatment with Liraglutide(P<0.05),but metformin had no effect.Conclusion For the elderly patients with type 2 diabetes mellitus,Liraglutide can effectively control blood sugar,regulate lipid metabolism,reduce insulin resistance,improve islet function and improve bone density.