聚乙二醇洛塞那肽注射液(PEX168)联合胰岛素对2型糖尿病合并骨质疏松患者糖代谢、骨代谢的影响

Effects of PEX168 combined with insulin on the glucose and bone metabolism in osteoporosis patients with type 2 diabetic

目的探讨聚乙二醇洛塞那肽注射液(PEX168)与胰岛素联合治疗对2型糖尿病合并骨质疏松患者的治疗效果,及对糖代谢和骨代谢的影响。方法将76例2型糖尿病合并骨质疏松患者按随机数字表法分为观察组(n=40)和对照组(n=36),对照组给予维生素D、抗骨质疏松药物(双磷酸盐)、门冬胰岛素50注射液治疗,并加强营养、膳食调节、充足日照。观察组另外给予聚乙二醇洛塞那肽注射液(PEX168)治疗,1次/周,0.2 mg/次皮下注射。余治疗同对照组。2组治疗时间均为12周。观察2组治疗前后糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)及体重指数(BMI)]、骨代谢指标[骨密度(BMD)、碱性磷酸酶(ALP)、血钙、Ⅰ型原胶原N端前肽(PINP)、骨钙素(OC)Ι型胶原羟基端肽β降解产物(β-CTX)],并统计2组患者的不良反应发生率。结果治疗后,2组FPG、2hPG、HbA1c和BMI均较治疗前降低(P<0.05),且观察组上述指标较对照组明显降低(P<0.05)。治疗后,2组的BMD、ALP、血钙、PINP、OC均较治疗前升高(P<0.05),观察组显著高于对照组(P<0.05);治疗后,2组β-CTX较治疗前降低(P<0.05),且观察组显著低于对照组(P<0.05)。2组患者的不良反应发生率无统计学差异。结论PEX168与胰岛素联合治疗可改善2型糖尿病骨质疏松患者的血糖,并改善患者的骨代谢情况。

Objective To investigate the effects of PEX168 combined with insulin on the glucose and bone metabolism in osteoporosis patients with type 2 diabetic.Methods Seventy-six osteoporosis patients with type 2 diabetic were randomly divided into observation group(n=40)and control group(n=36).The patients in both groups were treated by vitamin D,anti-osteoporosis drugs(bisphosphonates),insulin aspart 50 injection,strengthened nutrition,dietary adjustment and adequate sunshine for 12 weeks and those in observation group were treated with extra subcutaneous injection of PEX168 at 0.2mg once a week.The indexes of glucose metabolism(FPG,2hPG,HbA1c and BMI)and bone metabolism(BMD,ALP,PINP,OC andβ-CTX)as well as the incidences of adverse reactions were observed and compared between the two groups.Results After treatment,the levels of FPG,2hPG,HbA1c,BMI andβ-CTX in both groups decreased and those in observation group were more significant(P<0.05).The levels of BMD,ALP,blood calcium,N terminal propeptideⅠ(PINP)and osteocalcin(OC)in both groups increased and those in observation group were more significant(P<0.05).In addition,there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion PEX168 combined with insulin can improves blood glucose and bone metabolism in osteoporosis patients with type 2 diabetic.