利拉鲁肽治疗后2型糖尿病患者糖化血红蛋白与胱抑素C的相关性研究

Correlation between glycosylated hemoglobin and cystatin C in patients with type 2 diabetes after liraglutide treatment

目的观察利拉鲁肽治疗对2型糖尿病(T2DM)患者的糖代谢、脂代谢及血压的影响,并探讨利拉鲁肽治疗后患者糖化血红蛋白(HbA1c)与胱抑素C(Cys-C)的相关性。方法采用自身对比研究,选取2018年1月至2019年12月西安市第九医院收治的T2DM患者46例作为研究对象,行利拉鲁肽治疗12周,比较患者治疗前后的血糖、血脂、血压及Cys-C水平;采用Pearson相关系数分析治疗前后患者糖化血红蛋白变化(△HbA1c)与胱抑素C变化(△Cys-C)的相关性;并将患者根据治疗后的Cys-C水平变化分为Cys-C升高组和Cys-C未升高组,比较两组患者HbA1c<7%的达标率的差异。结果治疗12周后,患者的HbA1c、收缩压(SBP)、舒张压(DBP)、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)水平明显低于治疗前,而Cys-C水平明显高于治疗前,差异均有统计学意义(P<0.05);采用Pearson相关系数分析结果显示,△HbA1c与△Cys-C呈负相关(r=-0.383,P<0.05);Cys-C升高组患者的HbA1c<7%患者比例为53.9%,明显高于Cys-C未升高组的41.2%,差异有统计学意义(P<0.05)。结论利拉鲁肽治疗T2DM患者的降糖、降脂、降压效果显著,且Cys-C的动态变化可能反映利拉鲁肽的活性,对临床中使用利拉鲁肽降糖的疗效判断有指导意义。

Objective To observe the effects of liraglutide treatment on glucose metabolism,lipid metabolism and blood pressure in patients with type 2 diabetes(T2DM),and to investigate the correlation between glycosylated hemoglobin(HbA1c)and cystatin C(Cys-C)in patients after liraglutide treatment.Methods A self-comparison study was conducted on 46 T2DM patients who were admitted to the Ninth Hospital of Xi'an from January 2018 to December 2019.These patients were treated with liraglutide for 12 weeks.The blood glucose,blood lipids,blood pressure and Cys-C levels were compared before and after treatment.Pearson analysis was used to analyze the correlation between the change of glycosylated hemoglobin(△HbA1c)and cystatin C(△Cys-C)before and after treatment.The patients were divided into the Cys-C elevated group and the Cys-C non-elevated group according to the changes in Cys-C levels after treatment,and the difference in the compliance rate of HbA1c<7%was compared between the two groups.Results After 12 weeks of treatment,the levels of HbA1c,systolic blood pressure(SBP),diastolic blood pressure(DBP),cholesterol(TC),triglycerides(TG),and low-density lipoprotein(LDL-C)were significantly lower than those before treatment,while the level of cystatin C(Cys-C)was significantly higher than that before treatment,with statistically significant differences(P<0.05).Pearson correlation coefficient analysis showed that△HbA1c was negatively correlated with△Cys-C(r=-0.383,P<0.05).The compliance rate of HbA1c<7%was 53.9%in the Cys-C elevated group,which was significantly higher than 41.2%in the Cys-C non-elevated group(P<0.05).Conclusion Liraglutide has significant anti-diabetic,lipid-lowering and antihypertensive effects in the treatment of T2DM patients,and the dynamic changes of Cys-C may reflect the activity of liraglutide,which provides guidance for the curative efficacy of liraglutide in reducing blood sugar.