GLP-1类似物在糖尿病肾病患者中的疗效分析

Efficacy Analysis of GLP-1 Analogues in Patients with Diabetic Nephropathy

目的观察胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)类似物对2型糖尿病早期肾病患者的肾脏保护作用。方法2017年11月—2019年12月间选取使用GLP-1类似物并参与随访的2型糖尿病早期肾病患者30例,收集患者治疗6个月前后的体重,体质指数(body mass index,BMI),腰围,臀围,血糖,生化指标等,计算胰岛β细胞功能相关指标,进行对比分析。结果治疗后腰围、2 hPG、HbA1c、HOMA-IR、TC、TG、ALB、MA/Cr、UA较治疗前降低,HOMA-β较治疗前升高,差异有统计学意义(P<0.05)。Pearson相关性分析示:HbA1c与MA/Cr呈负相关性(r=-0.421,P<0.05);HOMA-β、TG、TC、UA与MA/Cr呈正相关性(r=0.777,P<0.05;r=0.757,P<0.05;r=0.470,P<0.05;r=0.443,P<0.05)。HbA1c与ALB呈负相关性(r=-0.433,P<0.05);HOMA-β、TG、TC、UA与ALB呈正相关性(r=0.723,P<0.05;r=0.756,P<0.05;r=0.493,P<0.05;r=0.374,P<0.05)。结论GLP-1类似物对2型糖尿病早期肾病患者有较好的降糖、调脂、改善胰岛功能、保护肾脏的作用,而且降血糖、降血脂、改善胰岛功能可能有益于肾脏保护。

Objective To observe the renal protective effect of glucagon-like peptide-1(GP-1)analogues on patients with type 2 diabetic early nephropathy.Methods From November 2017 to December 201930 patients with type 2 diabetes with early nephropathy who used GLP-1 analogues and participated in follow-up were selected.The weight,body mass index(BMI),waist circumference,hip circumference,blood glucose,and biochemistry indicators,etc.of the patients before and after 6 months of treatment were collected,calculate the relevant indicators of pancreatic β-cell function,and conduct comparative analysis.Results After treatment,waist circumference,2 hPG,HbA1c,HOMA-IR,TC,TG,ALB,MA/Cr,UA were lower than before treatment,and HOMA-βwas higher than before treatment,the difference was statistically significant(P<0.05).Pearson correlation analysis showed that:HbA1c was negatively correlated with MA/Cr(r=-0.421,P<0.05);HOMA-β,TG,TC,UA and MA/Cr were positively correlated(r=0.777,P<0.05;r=0.757,P<0.05;r=0.470,P<0.05;r=0.443,P<0.05).HbA1c was negatively correlated with ALB(r=-0.433,P<0.05);HOMA-β,TG,TC,UA were positively correlated with ALB(r=0.723,P<0.05;r=0.756,P<0.05;r=0.493,P<0.05;r=0.374,P<0.05).Conclusion GLP-1 analogues have good effects on lowering blood glucose,lowering lipids,improving islet function,and protecting the kidneys in patients with early nephropathy of type 2 diabetes,and lowering blood glucose,lowering blood lipids,and improving islet function may be beneficial to kidney protection.