利拉鲁肽联合二甲双胍对肥胖型多囊卵巢综合征患者性激素、胰岛素抵抗和脂肪细胞因子的影响

Effects of liraglutide combined with metformin on sex hormones,insulin resistance and adipocytokines in obese patients with polycystic ovary syndrome

目的:探讨利拉鲁肽联合二甲双胍治疗肥胖型多囊卵巢综合征(PCOS)患者的疗效。方法:选取100例肥胖型PCOS不孕患者为研究对象,按照治疗方案不同分为二甲双胍组与联合组,每组各50例。两组均予以生活方式干预,包括饮食控制、运动减重等,并予以达英-35服用。二甲双胍组予以盐酸二甲双胍片口服;联合组在二甲双胍组基础上予以利拉鲁肽治疗,两组均治疗3个月。比较两组间体质量指数(BMI)、腰臀比(WHR)、性激素指标[黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)]、稳态胰岛素β细胞抵抗指数(HOMA-IR)、糖脂代谢指标和脂肪细胞因子[瘦素(LEP)、脂联素(APN)]等水平。结果:治疗后,联合组BMI、WHR、LH、T、FPG、TG、TC、LDL-C、HOMA-IR和LEP水平均低于二甲双胍组(P<0.05),APN水平高于二甲双胍组(P<0.05)。随访3个月,联合组中月经周期≤45 d者为74.00%,高于二甲双胍组的54.00%(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:对于PCOS患者,利拉鲁肽联合二甲双胍能够更好地降低体重、纠正高雄激素血症、改善糖脂代谢和LEP、APN水平,有助于月经周期维持,且不增加不良反应。

Objective:To investigate the efficacy of liraglutide combined with metformin in the treatment of obese patients with polycystic ovary syndrome(PCOS).Methods:100 obese PCOS infertile patients were selected as the research subjects and divided into metformin group and combined group according to different treatment methods,with 50 cases in each group.Both groups were given lifestyle interventions,including diet control,exercise weight loss,etc.,and were given Diane-35.The metformin group was treated with metformin hydrochloride tablets orally,and the combined group was treated with liraglutide on the basis of the metformin group.Both groups were treated for 3 months.The levels of body mass index(BMI),waist-hip ratio(WHR),sex hormone indexes[luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T)],homeostasis insulin β cell resistance index(HOMA-IR),glucose and lipid metabolism indexes and adipocytokines[leptin(LEP),adiponectin(APN)]were compared between the two groups.Results:After treatment,BMI,WHR,LH,T,FPG,TG,TC,LDL-C,HOMA-IR and LEP in the combined group were lower than those in the metformin group(P<0.05).The level of APN was higher than that in the metformin group(P<0.05).After 3 months of follow-up,the proportion of menstrual cycle≤45 d in the combined group was 74.00%,which was higher than 54.00%in the metformin group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:For PCOS patients,liraglutide combined with metformin can better reduce body weight,correct hyperandrogenism,improve glucose and lipid metabolism and LEP and APN levels,help maintain menstrual cycle,and do not increase adverse reactions.