GLP-1受体激动剂联合益生菌对糖尿病患者肠道菌群、氧化应激和糖脂代谢的影响

Effects of GLP-1 receptor agonist combined with probiotics on intestinal flora,oxidative stress,glycolipid metabolism of patients with diabetes mellitus

目的探讨胰高血糖素样肽-1(GLP-1)受体激动剂联合益生菌对糖尿病患者肠道菌群、氧化应激、糖脂代谢的影响。方法选取2017年4月至2019年4月就诊的糖尿病患者212例,采用随机数字表法分为2组,对照组患者106例采用二甲双胍联合益生菌治疗,观察组患者106例采用GLP-1受体激动剂联合益生菌治疗,于治疗前后行肠道菌群、氧化应激、糖代谢、脂代谢、胰岛功能指标检测。结果2组患者治疗后双歧杆菌、乳酸杆菌、谷胱甘肽过氧化物酶、总抗氧化能力、高密度脂蛋白胆固醇、胰岛β细胞功能指数较本组治疗前升高(P<0.05)。2组患者治疗后肠杆菌、肠球菌、丙二醛、脂质过氧化氢、空腹血糖、餐后2h血糖、糖化血红蛋白、总胆固醇、低密度脂蛋白胆固醇、三酰甘油、空腹胰岛素、胰岛素抵抗指数较本组治疗前降低(P<0.05)。观察组患者治疗后双歧杆菌、乳酸杆菌、谷胱甘肽过氧化物酶、总抗氧化能力、高密度脂蛋白胆固醇、胰岛β细胞功能指数高于对照组(P<0.05)。观察组患者治疗后肠杆菌、肠球菌、丙二醛、脂质过氧化氢、空腹血糖、餐后2 h血糖、糖化血红蛋白、总胆固醇、低密度脂蛋白胆固醇、三酰甘油、空腹胰岛素、胰岛素抵抗指数低于对照组(P<0.05)。结论GLP-1受体激动剂联合益生菌可改善糖尿病患者的肠道菌群,减轻氧化应激反应,并改善糖脂代谢状况。

Objective To investigate the effects of glucagon like peptide-1(GLP-1)receptor agonist combined with probiotics on intestinal flora,oxidative stress,glycolipid metabolism of patients with diabetes mellitus.Methods A total of 212 patients with diabetes mellitus who were treated in our hospital from April 2017 to April 2019 were enrolled in the study,who were divided into two groups according to random digital table method,with 106 patients in each group.The patients in control group were treated by metformin combined with probiotics,however,the patients in observation group were treated by GLP-1 receptor agonist combined with probiotics.the intestinal flora,oxidative stress,glucose metabolism,lipid metabolism,islet function before and after treatment were observed and compared between the two groups.Results After treatment the levels of bifidobacterium,lactobacillus,glutathione peroxidase,total antioxidant capacity,high-density lipoprotein cholesterol,isletβcell function index were significantly increased in both groups(P<0.05),however,the levels of enterobacter,enterococcus,malondialdehyde,lipid hydrogen peroxide,fasting blood glucose,postprandial 2h blood glucose,glycosylated hemoglobin,total cholesterol,low-density lipoprotein cholesterol,triglyceride,fasting insulin,insulin resistance index were significantly decreased in both groups(P<0.05).After treatment the levels of bifidobacterium,lactobacillus,glutathione peroxidase,total antioxidant capacity,high-density lipoprotein cholesterol,isletβcell function index in observation group were significantly higher than those in control group(P<0.05),however,the levels of enterobacter,enterococcus,malondialdehyde,lipid hydrogen peroxide,fasting blood glucose,postprandial 2h blood glucose,glycosylated hemoglobin,total cholesterol,low-density lipoprotein cholesterol,triglyceride,fasting insulin,insulin resistance index in observation group were significantly lower than those in control group(P<0.05).Conclusion GLP-1 receptor agonist combined with probiotics can improve intestinal flora and reduce oxidative stress,which can also improve glucose and lipid metabolism of patients with diabetes mellitus.