利拉鲁肽对初诊肥胖老年2型糖尿病病人血清趋化素、胰岛素样生长因子-1水平及胰岛功能的影响研究

Effect of liraglutide on serum Chemerin,IGF-1 and lslet function in newly diagnosed obese elderly patients with type 2 diabetes mellitus

目的探讨利拉鲁肽对初诊肥胖的老年T2DM病人血清趋化素(Chemerin)、胰岛素样生长因子-1(IGF-1)水平及胰岛功能的影响。方法选择2019年1~12月初诊肥胖的128例老年T2DM病人作为研究对象,采用抽签法分为观察组和对照组,每组各64例。观察组采用利拉鲁肽治疗干预,对照组采用胰岛素强化治疗干预,2组均完成12周治疗。比较2组病人治疗前后BMI、血糖、血清空腹胰岛素(FINS)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、血清Chemerin、IGF-1水平变化情况以及2组病人治疗过程中不良反应发生情况。结果治疗12周后,观察组BMI显著低于治疗前及对照组(P<0.05),但对照组BMI与治疗前差异无统计学意义(P>0.05)。治疗12周后,2组FPG、HbA1c、HOMA-IR、血清Chemerin、IGF-1水平均低于治疗前(P<0.05),FINS、HOMA-β水平均高于治疗前(P<0.05),且观察组上述指标改善情况均优于对照组(P<0.05)。2组治疗过程中总不良反应发生率差异无统计学意义(P>0.05)。结论利拉鲁肽应用于初诊肥胖的老年T2DM病人安全性高,能降低病人的BMI、血糖、血清Chemerin、IGF-1水平,改善胰岛素抵抗及胰岛B细胞功能,值得临床推广应用。

Objective To explore the effects of liraglutide on serum Chemerin,insulin-like growth factor-1(IGF-1)levels and islet function in the newly diagnosed obese elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 128 elderly patients with T2DM who were diagnosed as obese from January to December 2019 were selected as the research objects.They were divided into observation group and control group by lottery method,with 64 cases in each group.The observation group was treated with liraglutide,and the control group was treated with intensive insulin treatment.Both groups received 12 weeks of treatment.The levels of body mass index(BMI),blood glucose,serum fasting insulin(FINS),isletβ-cell function index(HOMA-β),insulin resistance index(HOMA-IR),serum Chemerin and IGF-1 before and after treatment were compared between the two groups,and the incidence of adverse reactions of the two groups were observed.Results After 12 weeks of treatment,the level of BMI of the observation group was significantly lower than that before treatment and that of the control group(P<0.05),but BMI showed no significant difference in the control group before and after treatment(P>0.05).After 12 weeks of treatment,the levels of fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),HOMA-IR,serum Chemerin and IGF-1 in the two groups were lower than those before treatment(P<0.05),and FINS and HOMA-βlevels were higher than those before treatment(P<0.05),especially in the observation group(P<0.05).There was no significant difference in the incidence of total adverse reactions between the two groups during the treatment(P>0.05).Conclusions Liraglutide can reduce the levels of BMI,blood sugar,serum Chemerin and IGF-1,and improve the insulin resistance and islet B cell function in newly diagnosed obese elderly T2DM patients.