利拉鲁肽联合阿法骨化醇对老年2型糖尿病伴骨质疏松患者糖脂代谢和骨代谢的影响

Effects of Liraglutide Combined with Alfacalcidol on Glucose-lipid Metabolism and Bone Metabolism in Elderly Patients with Type 2 Diabetes Mellitus and Osteoporosis

目的探讨利拉鲁肽联合阿法骨化醇对老年2型糖尿病伴骨质疏松患者糖脂代谢和骨代谢的影响。方法选取2018年5月至2020年5月在本院确诊的92例老年2型糖尿病伴骨质疏松患者,采用简单随机分组的方法将患者分为观察组(n=46),采用基础降糖治疗的同时采用利拉鲁肽联合阿法骨化醇治疗)和对照组(n=46),采用基础降糖治疗的同时阿法骨化醇治疗),两组患者均持续治疗12周。分别于治疗前后,观察两组患者的血糖(FBG)、糖基化血红蛋白(HbAlc)、甘油三脂(TG)、总胆固醇(TC)、骨碱性磷酸酶(BALP)、抗酒石酸酸性磷酸酶5b(TRAP-5b)、β-胶原特殊序列(β-CTX)、25羟维生素D[25-(OH)-D]水平的变化及不良反应发生率。结果治疗12周后,两组患者的FBG、HbAlc、TG较治疗前显著降低(P<0.05),TC水平无明显变化(P>0.05);治疗后,两组患者血清BALP、TRAP-5b、β-CTX水平均明显降低(P<0.05),25(OH)D较治疗前升高(P<0.05)。治疗期间,观察组患者不良反应发生率为10.87%,与对照组患者的15.22%无显著差异(P>0.05)。结论利拉鲁肽联合阿法骨化醇治疗可以有效改善糖脂代谢,调节骨代谢,不良反应少,安全性高。

Objective To explore the effects of liraglutide combined with alfacalcidol on glucose-lipid metabolism and bone metabolism in elderly patients with type 2 diabetes mellitus(T2DM)and osteoporosis.Methods A total of 92 elderly patients confirmed with T2DM and osteoporosis in the hospital were enrolled between May 2018 and May 2020.They were divided into observation group and control group by simple random grouping method,46 cases in each group.All were given basic hypoglycemic therapy.On this basis,control group was treated with alfacalcidol,while observation group was treated with liraglutide and alfacalcidol for 12 weeks.Before and after treatment,changes in levels of fasting blood glucose(FBG),glycosylated hemoglobin(HbAlc),total cholesterol(TC),triglyceride(TG),bone alkaline phosphatase(BALP),anti-tartrate acid phosphatase 5b(TRAP-5b),β-collagen special sequence(β-CTX)and 25-hydroxyvitamin D[25-(OH)-D],and adverse reactions in both groups were observed.Results After treatment,FBG,HbAlc and TG were significantly decreased in both groups(P<0.05),and there was no significant change in TC level before and after treatment(P>0.05).After treatment,levels of serum BALP,TRAP-5b andβ-CTX were significantly decreased(P<0.05),while 25(OH)D was increased in both groups(P<0.05).The incidence of adverse reactions during treatment between observation group and control group was not statistically significant(10.87%vs 15.22%)(P>0.05).Conclusion Liraglutide combined with alfacalcidol can effectively improve glucose-lipid metabolism and regulate bone metabolism,with few adverse reactions and high safety.