度拉糖肽联合密盖息鼻喷剂治疗2型糖尿病合并骨质疏松患者的疗效及对炎症和脂肪因子影响的研究

Effects of Dulaglutide and Miacalcic on type 2 diabetes mellitus complicated with osteoporosis and on inflammatory factors and adipokines

目的探讨度拉糖肽联合密盖息鼻喷剂治疗T2DM合并骨质疏松(OP)患者的疗效及对炎症和脂肪因子的影响。方法选取2019年10月至2021年11月于海安市人民医院内分泌科及扬州大学医学院附属海安医院骨科门诊治疗的T2DM合并OP患者98例,随机分为密盖息鼻喷剂治疗组(MIA组)和度拉糖肽联合密盖息鼻喷剂治疗组(DUL+MIA组),每组各49例,均接受基础降糖、钙剂治疗。治疗6个月后比较两组FPG、2 hPG、HbA1c、骨密度(BMD)、骨钙素(BGP)、β胶原降解产物(β-CTX)、1型胶原氨基端延长肽(P1NP)、人抗酒石酸酸性磷酸酶5b(TRAP-5b)、IL-6、TNF-α、单核细胞趋化蛋白(MCP-1)、前脂肪因子1(Pref-1)、APN、内脏脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)的水平。结果两组治疗后FPG、2 h PG、HbA1c、β-CTX、P1NP、TRAP-5b、IL-6、TNF-α、MCP-1、Pref-1、APN低于治疗前,且DUL+MIA组低于MIA组(P<0.05)。两组治疗后BMD、BGP、Vaspin高于治疗前,且DUL+MIA组高于MIA组(P<0.05)。结论度拉糖肽联合密盖息鼻喷剂对T2DM合并OP患者在降糖、改善BMD及骨代谢效果较好,可有效改善血清炎症因子及脂肪因子。

Objective To investigate the effect of Dulaglutide combined with Miacalcic nasal spray on patients with type 2 diabetes mellitus(T2DM)combined with osteoporosis(OP),and also on the levels of blood inflammatory factors and adipokines.Methods A total of 98 patients with T2DM combined with OP from the clinic of Department of Endocrinology of Haian People’s Hospital and the Department of Orthopedics of Haian Hospital Affiliated to Yangzhou University Medical College were enrolled in this study from October 2019 to November 2021.All the participants were randomly divided into two groups:control group was treated with Miacalcic nasal spray(MIA group,n=49)and observation group was treated with Dulaglutide combined with Miacalcic nasal spray(DUL+MIA group,n=49).Patients received hypoglycemic and calcium agent treatment in both groups.After 6-month treatment,FPG,2 hPG,HbA1c,bone density(BMD),BGP,β-CTX,P1NP,TRAP-5b,IL-6,TNF-α,MCP-1,Pref-1,APN,and Vaspin were compared with baseline.Results Compared with baseline in the same group,FPG,2 hPG,HbA1c,β-CTX,P1NP,TRAP-5b,IL-6,TNF-α,MCP-1,Pref-1 and APN reduced after treatment in both groups(P<0.05),and the indexes were lower in DUL+MIA group than in MIA group(P<0.05).Compared with baseline in the same group,BMD,BGP and Vaspin after treatment in both groups(P<0.05),and the aboves indexes were higher in DUL+MIA group than in MIA group(P<0.05).Conclusion Dulaglutide combined with Miacalcic nasal spray had a good effect in lowering glucose and improving bone density and bone metabolism index in patients with T2DM combined with OP,and can improve the levels of blood inflammatory factors and adipokines effectively.