利拉鲁肽和达格列净对绝经后超重/肥胖2型糖尿病患者骨密度和骨转换标志物临床作用影响的研究

Effects of Liraglutide and Dapagliflozin on bone mineral density and bone turnover markers in postmeno⁃pausal overweight/obese patients with type 2 diabetes mellitus

目的观察利拉鲁肽和达格列净对绝经后超重/肥胖T2DM患者骨密度(BMD)和骨转换标志物临床作用的影响。方法选取2018年2~12月于安徽医科大学第二附属医院内分泌科门诊或住院的绝经后超重/肥胖T2DM患者63例,随机分为利拉鲁肽组(Lir,n=32)和达格列净组(Dap,n=31)。比较两组治疗前及治疗26周后FPG、TC、LDL⁃C、BMD、骨转换标志物I型胶原C末端肽交联(β⁃CTX)、1型胶原N端前肽(P1NP)和碱性磷酸酶(AKP)水平。结果两组治疗后BMI、FPG、HbA1c、TG、TC及LDL⁃C低于治疗前,P1NP高于治疗前(P<0.05)。两组治疗后比较,Dap组TC、LDL⁃C、β⁃CTX高于Lir组,L2⁃4 BMD、P1NP低于Lir组(P<0.05)。Lir组治疗后P1NP高于治疗前,β⁃CTX低于治疗前(P<0.05)。Dap组β⁃CTX高于治疗前(P<0.05)。结论利拉鲁肽、达格列净有降糖和减重作用。利拉鲁肽可抑制骨吸收,促进骨形成,可能对骨代谢有保护作用。

Objective To observe the effects of Liraglutide and Dapagliflozin on bone mineral density and bone turnover markers in postmenopausal overweight/obese type 2 diabetes mellitus(T2DM).Methods 63 postmenopausal overweight/obese T2DM patients were randomly divided into Liraglutide group(Lir,n=32)and Dapagliflozin group(Dap,n=31)from February to December,2018.The levels of FPG,TC,LDL⁃C,BMD,C⁃terminal peptide cross⁃linking(β⁃CTX),N⁃terminal pro peptide of type 1 collagen(P1NP)and alkaline phosphatase(AKP)were compared between the two groups before and after 26 weeks of treatment.Results After treatment,BMI,FPG,HbA1c,TG,TC and LDL⁃C of the two groups were lower than those before treatment,and P1NP was higher than that before treatment(P<0.05).After treatment,TC,LDL⁃C andβ⁃CTX in Dap group were higher than those in Lir group,and L2⁃4 BMD and P1NP were lower than those in Lir group(P<0.05).In Lir group,P1NP was higher than that before treatment,andβ⁃CTX was lower than that before treatment(P<0.05).The level ofβ⁃CTX in Dap group was higher than that before treatment(P<0.05).Conclusion Liraglutide and Dapagliflozin have hypo⁃glycemic and weight⁃loss effects.Liraglutide can inhibit bone resorption and promote bone formation,which may have a protective effect on bone metabolism.