利拉鲁肽治疗T2DM合并骨质疏松效果观察及对血清趋化素和骨密度的影响

Efficacy of liraglutide in the treatment of type 2 diabetes mellitus complicated by osteoporosis and its effects on serum chemokines and bone mineral density

目的观察利拉鲁肽治疗2型糖尿病(T2DM)合并骨质疏松的临床效果及其对患者血清趋化素和骨密度的影响。方法采用病例对照研究,回顾性分析厦门大学附属第一医院思明院区2019年5月至2021年9月收治的T2DM合并骨质疏松患者78例的临床资料,按照治疗方法不同分为观察组、对照组各39例。对照组给予阿法骨化醇辅助治疗,观察组在对照组的基础上给予利拉鲁肽治疗,两组治疗16周。比较两组临床治疗效果,观察两组治疗前后血清趋化素和骨密度水平,评价两组的不良反应。结果观察组总有效率为92.3%(36/39),高于对照组的71.8%(28/39),差异有统计学意义(χ^(2)=5.57,P<0.05)。治疗后,观察组血清趋化素[(60.11±10.25)μg/L]低于对照组[(63.15±10.24)μg/L],骨密度[(1.77±1.05)g/cm^(2)]高于对照组[(1.01±0.06)g/cm^(2)],差异均有统计学意义(t=-2.01、4.51,均P<0.05)。观察组不良反应发生率为7.7%(3/39),与对照组的12.8%(5/39)比较,差异无统计学意义(χ^(2)=0.56,P>0.05)。结论利拉鲁肽治疗T2DM合并骨质疏松有较好的疗效,可有效改善血清趋化素水平,提高骨密度水平,值得临床应用。

Objective To investigate the clinical efficacy of liraglutide in the treatment of type 2 diabetes mellitus complicated by osteoporosis and its effects on serum chemokines and bone mineral density.Methods This is a case-control study.The clinical data of 78 patients with type 2 diabetes mellitus complicated by osteoporosis who received treatment in the Siming Branch of The First Affiliated Hospital of Xiamen University from May 2019 to September 2021 were retrospectively analyzed.These patients were divided into an observation group and a control group(n=39 per group)according to different treatment methods.The control group was treated with adjuvant therapy with afacalcitol,while the observation group was given liraglutide in addition to adjuvant therapy with afacalcitol.Both groups were treated for 16 weeks.Clinical efficacy was compared between the two groups.Before and after treatment,serum chemokines and bone mineral density were determined in each group.Adverse reactions were evaluated in each group.Results The total effective rate in the observation group was 92.3%(36/39),which was significantly higher than 71.8%(28/39)in the control group(χ^(2)=5.57,P<0.05).After treatment,the serum chemokine level in the observation group was(60.11±10.25)μg/L,which was significantly lower than(63.15±10.24)μg/L in the control group(t=-2.01,P<0.05).Bone mineral density in the observation group was(1.77±1.05)g/cm^(2),which was significantly higher than(1.01±0.06)g/cm^(2)in the control group(t=4.51,P<0.05).The incidence of adverse reactions in the observation group was 7.7%(3/39),which was not significantly different from 12.8%(5/39)in the control group(χ^(2)=0.56,P>0.05).Conclusion Liraglutide is highly effective on type 2 diabetes mellitus complicated by osteoporosis.Liraglutide can effectively decrease serum chemokine levels,increase bone mineral density,and thereby is worthy of clinical application.