利拉鲁肽对腹型肥胖2型糖尿病患者网膜素水平影响

Effect of liraglutide on omentin levels in type 2 diabetes patients with abdominal obese

目的观察利拉鲁肽对腹型肥胖的2型糖尿病(T2DM)患者血浆网膜素(omentin)-1水平的影响。方法 选取河北中石油中心医院2019年1月~2021年1月收治的106例腹型肥胖血糖控制不佳的T2DM患者,随机数表法分为两组,每组53例。二甲双胍组口服盐酸二甲双胍片,利拉鲁肽组二甲双胍联合利拉鲁肽注射液,两组均干预20周。比较两组治疗前后血糖、血脂、体质量指数(BMI、腰围、内脏脂肪面积(visceral fat area,VFA)、omentin-1水平,分析网膜素-1与腰围、BMI、VFA的相关性。结果 治疗后,两组FPG、HbA1c均低于治疗前,差异有统计学意义(P <0.05),但两组间差异无统计学意义(P> 0.05)。利拉鲁肽组TG低于二甲双胍组,差异有统计学意义(P <0.05)。两组omentin-1高于治疗前,其中利拉鲁肽组治疗前后比较差异有统计学意义,且治疗后利拉鲁肽组omentin-1高于二甲双胍组,差异有统计学意义(P <0.05)。二甲双胍组omentin-1治疗前后差异无统计学意义(P <0.05)。利拉鲁肽组BMI、腰围、VFA均低于治疗前和二甲双组,差异均有统计学意义(P <0.05)。血浆omentin-1浓度与BMI、腰围、VFA均呈负相关(r=-0.302、-0.336、-0.417)。多因素回归分析显示腰围、VFA为omentin-1水平的独立影响因素。结论 腹型肥胖的T2DM患者,血浆网膜素-1与BMI、腰围、VFA显著相关,腰围和VFA是其独立影响因素,利拉鲁肽可改善胰岛素抵抗、降低内脏脂肪减重,其机制可能与影响网膜素表达相关。

Objective To observe the effect of liraglutide on plasma omentin-1 level in T2DM patients with abdominal obesity.Methods 106 T2DM patients with abdominal obesity who had poor blood glucose control were randomly divided into two groups,53 patients in each group.Metformin hydrochloride tablets were taken orally in the metformin group,and metformin combined with liraglutide injection in the liraglutide group.Both groups were intervened for 20 weeks.The blood glucose,blood lipid,BMI,waist circumference,visceral fat area(VFA),and ometin-1 levels were compared between the two groups before and after treatment,and the correlation between omentin-1 and waist circumference,BMI,VFA was analyzed.Results After treatment,FPG and HbA1c in the two groups were lower than those before treatment,with statistically significant difference,but there was no statistically significant difference between the two groups.TG in the liraglutide group was lower than that in the metformin group,with a statistically significant difference(P<0.05).omentin-1 in the two groups was higher than that before treatment,and there was a statistically significant difference between before and after treatment in the liraglutide group,and after treatment,omentin-1 in the liraglutide group was higher than that in the metformin group,with a statistically significant difference(P<0.05).There was no significant difference in omentin-1 before and after treatment in metformin group(P<0.05).BMI,waist circumference and VFA in the liraglutide group were lower than those before treatment and those in the two groups,the difference was statistically significant(P<0.05).The plasma ometin-1 concentration was negatively correlated with BMI,waist circumference and VFA,and the correlation coefficients were-0.302,-0.336 and-0.417 respectively.Multivariate regression analysis showed that waist circumference and VFA were independent influencing factors of omentin-1 level.Conclusion In T2DM patients with abdominal obesity,plasma omentin 1 is significantly correlated with BMI,waist circumference and VFA.Waist circumference and VFA are independent influencing factors.Lilalutide can improve insulin resistance and reduce visceral fat loss,and its mechanism may be related to the influence on the expression of omentin.