利拉鲁肽对超重男性2型糖尿病患者骨代谢的影响

Effect of Liraglutide on Bone Metabolism in Overweight Male Patients with Type 2 Diabetes

目的:探讨利拉鲁肽对超重男性2型糖尿病患者骨代谢的影响。方法:选取2018年2-9月本院收治的初次诊断为2型糖尿病男性超重患者72例,按随机数字表法分为对照组与研究组,各36例。对照组予以二甲双胍治疗,研究组在对照组基础上予以利拉鲁肽治疗。观察并比较两组治疗前、治疗24周与48周后血糖、BMI水平、骨代谢指标及不良反应发生情况。结果:研究组治疗24、48周后空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)、BMI水平均明显低于对照组(P<0.05);研究组治疗24、48周后维生素D3[25(OH)D3]、骨钙素(OC)、总Ⅰ型胶原氨基端延长肽(PⅠNP)及骨特异性碱性磷酸酶(BAP)均明显高于对照组,而β-胶原降解产物(β-CTX)水平均明显低于对照组(P<0.05)。对照组胃肠道反应发生率27.78%虽高于研究组发生率16.67%,但差异无统计学意义(P>0.05)。结论:利拉鲁肽可有效降低超重男性2型糖尿病患者血糖水平和体质量,改善骨代谢,骨形成增加、骨吸收减少,不良反应少且轻微,可在临床中广泛推广和应用。

Objective:To investigate the effects of Liraglutide on bone metabolism in overweight male patients with type 2 diabetes.Method:A total of 72 overweight male patients with type 2 diabetes initially diagnosed with type 2 diabetes in our hospital from February to September 2018 were selected and divided into control group and study group according to the random number table method,36 cases in each group.The control group was treated with Metformin.The study group was treated with Liraglutide on the basis of the control group.Blood glucose,BMI,bone metabolism and adverse reactions were observed and compared between the two groups before treatment,after 24 and 48 weeks of treatment.Result:Fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG),glycosylated hemoglobin(HbA1 c)and BMI in the study group were significantly lower than those in the control group after 24 and 48 weeks of treatment(P<0.05).The levels of vitamin D3[25(OH)D3],osteocalcin(OC),total collagenⅠamino terminal extension peptide(PⅠNP)and bone-specific alkaline phosphatase(BAP)in the study group were significantly higher than those in the control group after 24 and 48 weeks of treatment,while the levels of β-collagen degradation products(β-CTX)were significantly lower than those in the control group(P<0.05).The incidence of gastrointestinal reactions in the control group was 27.78% higher than 16.67%in the study group,but the difference was not statistically significant(P>0.05).Conclusion:Liraglutide can effectively reduce blood glucose level and body mass in overweight male patients with type 2 diabetes,improve bone metabolism,increase bone formation,reduce bone resorption,and have fewer and mild adverse reactions,which can be widely promoted and applied in clinical practice.