利拉鲁肽联合睾酮治疗2型糖尿病合并肥胖的效果研究

Therapeutic effects of liraglutide combined with testosterone on type 2 diabetes mellitus complicated by obesity

目的观察利拉鲁肽联合睾酮补充治疗2型糖尿病(T2DM)合并肥胖的临床疗效。方法T2DM合并肥胖患者96例随机分为对照组和观察组,每组48例。2组均接受降糖、降脂、降压、饮食指导、运动锻炼等常规治疗。对照组给予利拉鲁肽治疗,观察组在对照组基础上加用十一酸睾酮胶丸治疗,疗程3个月。比较2组临床疗效及治疗前后血糖[空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)]、血脂[总胆固醇(TC)、三酰甘油(TG)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)]、胰岛β细胞功能[胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]、体质量指数(BMI)、脂肪率、脂肪因子[脂联素(ADP)、抵抗素(Resistin)]、氧化应激[丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)]变化。结果治疗后,观察组总有效率明显高于对照组(P<0.05)。治疗前,2组FPG、2 hPG、HbA1c、TC、TG、ApoA1、ApoB、HOMA-β、HOMA-IR、BMI、脂肪率、ADP、Resistin、MDA、GSH-Px、SOD比较差异无统计学意义(P>0.05);治疗后,2组FPG、2 hPG、HbA1c、TC、TG、ApoB、HOMA-IR、BMI、脂肪率、Resistin、MDA均明显低于治疗前(P<0.05),ApoA1、HOMA-β、ADP、GSH-Px、SOD均明显高于治疗前(P<0.05),且观察组上述指标变化幅度大于对照组(P<0.05)。结论利拉鲁肽联合睾酮补充治疗T2DM合并肥胖疗效显著,能够有效纠正糖脂代谢紊乱,保护胰岛β细胞功能,其机制与调节脂肪因子分泌及抑制氧化应激有关。

Objective To investigate the therapeutic effects of liraglutide combined with testosterone on type 2 diabetes mellitus(T2DM)complicated by obesity.Methods Ninety-six patients with T2DM complicated by obesity were randomly divided into control group(n=48)and observation group(n=48).On the basis of routine treatment,the patients in control group were treated by liraglutide while the patients in observation group were treated by liraglutide combined with testosterone.After 3-month treatment,the clinical efficacy as well as the levels of blood glucose(FPG,2 hPG and HbA1c),blood lipids(TC,TG,ApoA1 and ApoB),pancreatic beta cell function(HOMA and HOMA-IR),BMI,fat rate,adipokine(ADP and Resistin),oxidative stress(MDA,GSH-Px and SOD)before and after treatment were observed and compared between the two groups.Results Before treatment,there were no significant differences in FPG,2hPG,HbA1c,TC,TG,ApoA1,ApoB,HOMA,HOMAIR,BMI,fat rate,ADP,Resistin,MDA,GSHPx and SOD between two groups(P>0.05).After treatment,the total effective rate in observation group was significantly higher than that in control group(P<0.05).Moreover,the levels of FPG,2 hPG,HbA1c,TC,TG,ApoB,HOMA-IR,BMI,fat rate,Resistin and MDA in both groups were significantly decreased(P<0.05),however,the levels of ApoA1,HOMA-β,ADP,GSH-Px and SOD in both groups were significantly increased(P<0.05).And the changes of the indexes mentioned above in observation group were more significant than those in control group(P<0.05).Conclusion Liraglutide combined with testosterone is quite effective in treating T2DM complicated by obesity,which can significantly control the glucolipid metabolism levels and protect pancreatic beta cell function.Its action mechanism may be associated with the modulation of adipokine secretion and the inhibition of oxidative stress.