利拉鲁肽联合二甲双胍治疗2型糖尿病肥胖患者的效果观察

Effect of liraglutide combined with metformin in the treatment of obese patients with type 2 diabetes mellitus

目的观察利拉鲁肽联合二甲双胍治疗2型糖尿病肥胖患者的临床效果。方法64例2型糖尿病肥胖患者,根据治疗方法的不同分为对照组及观察组,每组32例。对照组予以盐酸二甲双胍片口服治疗,观察组在对照组基础上予以利拉鲁肽皮下注射治疗。比较两组患者治疗前后的血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、血脂指标[高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)]、胰岛功能指标[空腹胰岛素(FINS)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]、体质量指数(BMI)。结果治疗后,两组患者的FPG、2 h PG、HbA1c均较本组治疗前降低,且观察组患者的FPG(6.12±0.85)mmol/L、2 h PG(9.13±0.96)mmol/L、HbA1c(5.94±0.53)%低于对照组的(7.27±0.93)mmol/L、(10.21±1.32)mmol/L、(6.61±0.65)%,差异均具有统计学意义(P<0.05)。治疗后,两组患者的TC、LDL-C、TG均较本组治疗前降低,HDL-C均较本组治疗前升高,且观察组患者的TC(5.23±0.35)mmol/L、LDL-C(3.81±0.18)mmol/L、TG(2.02±0.17)mmol/L低于对照组的(6.21±0.39)、(4.12±0.23)、(2.56±0.24)mmol/L,HDL-C(1.05±0.07)mmol/L高于对照组的(0.97±0.08)mmol/L,差异均具有统计学意义(P<0.05)。治疗后,两组患者的FINS、HOMA-β均较本组治疗前升高,HOMA-IR、BMI均较本组治疗前降低,且观察组患者的FINS(6.93±0.47)μIU/ml、HOMA-β(50.07±4.71)高于对照组的(5.54±0.42)μIU/ml、(34.82±3.98),HOMA-IR(4.34±0.58)、BMI(25.83±0.98)kg/m^(2)低于对照组的(6.42±0.45)、(26.90±1.13)kg/m^(2),差异均具有统计学意义(P<0.05)。结论利拉鲁肽联合二甲双胍不但可以明显改善2型糖尿病肥胖患者糖脂代谢及胰岛素功能,还可减轻患者的体质量。

Objective To observe the clinical effect of liraglutide combined with metformin in the treatment of obese patients with type 2 diabetes mellitus.Methods A total of 64 cases of obese patients with type 2 diabetes mellitus were divided into control group and observation group according to different treatment methods,with 32 cases in each group.The control group was treated with oral administration of metformin hydrochloride tablets,and the observation group was treated with subcutaneous injection of liraglutide on the basis of the control group.Both groups were compared in terms of blood glucose indexes[fasting plasma glucose(FPG),2 h postprandial glucose(2 h PG),glycosylated hemoglobin(HbA1c)],blood lipid indexes[high-density lipoprotein cholesterol(HDL-C),total cholesterol(TC)],[low density lipoprotein cholesterol(LDL-C),triglyceride(TG)],pancreatic islet function indexes[fasting insulin(FINS),homeostasis model assessment-β cell function(HOMA-β),homeostasis model assessment-insulin resistance(HOMA-IR)],body mass index(BMI)before and after treatment.Results After treatment,the FPG,2 h PG and HbA1c of the two groups were all lower than those of this group before treatment,and the FPG(6.12±0.85)mmol/L,2 h PG(9.13±0.96)mmol/L,and HbA1c(5.94±0.53)% of the observation group lower than(7.27±0.93)mmol/L,(10.21±1.32)mmol/L,and(6.61±0.65)% of the control group.All the differences were statistically significant(P<0.05).After treatment,the TC,LDL-C and TG of the two groups were lower than those of this group before treatment,and the HDL-C was higher than that of this group before treatment;the TC(5.23±0.35)mmol/L,LDL-C(3.81±0.18)mmol/L,and TG(2.02±0.17)mmol/L in the observation group were lower than(6.21±0.39),(4.12±0.23),(2.56±0.24)mmol/L in the control group,and the HDL-C(1.05±0.07)mmol/L was higher than(0.97±0.08)mmol/L in the control group;all the differences were statistically significant(P<0.05).After treatment,the levels of FINS and HOMA-βin the two groups were increased compared with those of this group before treatment,and the HOMA-IR and BMI were decreased compared with those of this group before treatment;the FINS(6.93±0.47)μIU/ml,HOMA-β(50.07±4.71)of the observation group were higher than(5.54±0.42)μIU/ml,(34.82±3.98)of the control group,and the HOMA-IR(4.34±0.58),BMI(25.83±0.98)kg/m^(2) were lower than(6.42±0.45),(26.90±1.13)kg/m^(2) of the control group;all the differences were statistically significant(P<0.05).Conclusion Liraglutide combined with metformin can not only improve glycolipid metabolism and insulin function,but also reduce body weight in obese patients with type 2 diabetes mellitus.