GLP-1RA联合ZOL治疗老年2型糖尿病性骨质疏松患者的临床研究

Clinical Effect of GLP-1RA Combined with ZOL Treating Diabetic Osteoporosis Patients

目的观察胰高血糖素样肽1激动剂(GLP-1RA)度拉糖肽联合唑来膦酸注射液(ZOL)治疗老年2型糖尿病(T2DM)性骨质疏松(DOP)患者的临床疗效。方法采用前瞻性随机对照研究,选取2020年1月至2021年12月就诊于我院的老年T2DM DOP患者56例,采用随机数字表法分为观察组和对照组各28例;对照组使用甘精胰岛素联合唑来磷酸注射液,观察组使用度拉糖肽联合唑来磷酸注射液;治疗周期为6个月。观察两组患者治疗前后糖化血红蛋白(HbA1c)、体质量、葡萄糖范围内时间(TIR)、β胶原降解产物(β-CTX)、骨钙素(OC)、1型胶原氨基端延长肽(P1NP)、碱性磷酸酶(ALP)、血清骨特异性碱性磷酸酶(BAP)和护骨素(OPG)的差异。结果两组患者治疗前基线资料差异无统计学意义(P>0.05);治疗后两组HbA1c、体质量、TIR、β-CTX、OC、P1NP、ALP、BAP和OPG均明显改善(P<0.05);且两组间HbA1c、TIR、β-CTX、OC、BAP差异有统计学意义(P<0.05);观察组患者体质量、P1NP、ALP和OPG的改善幅度均优于对照组;治疗后两组患者均未发生严重低血糖、消化系统、过敏等严重不良反应。结论GLP-1RA度拉糖肽联合ZOL能明显改善老年DOP患者HbA1c、体质量、TIR、β-CTX、OC、P1NP、ALP、BAP和OPG;疗效优于甘精胰岛素联合ZOL。

Obective To observe the clinical effect of glucagon-like peptide-1 agonist(GLP-1RA)dolateptide combined with Zoledronic acid injection(ZOL)on elderly patients with type 2 diabetes mellitus(T2DM)osteoporosis(DOP).Method In this prospective randomized controlled study,56 elderly T2DM DOP patients admitted to our hospital from January 2020 to December 2021 were selected and divided into observation group and control group with 28 cases in each group by random number table method.The control group was treated with Insulin glargine combined with ZOL,the observation group was treated with Dulaglutide combined with ZOL,the curation period was 6 months.We collected the basical and clinical data,observed HbA1c、weight、TIR、β-CTX、OC、P1NP、ALP、BAP and OPG before and after the curation.Results The baseline data between the two groups had no signiaficant defference(P>0.05);After the curation,HbA1c、weight、TIR、β-CTX、OC、P1NP、ALP、BAP and OPG in the two groups obviously improved(P<0.05);After the curation,HbA1c、TIR、β-CTX、OC and BAP between the two groups had obvious defferences(P<0.05);the improvement of weight、P1NP、ALP and OPG in observation group was higher than that in control group;The incidence of adverse reactions between the two groups had no obvious difference.Conclusion GLP-1RA(Dulaglutide)combined with ZOL can improve the diabetic osteoporosis patients HbA1c、weight、TIR、β-CTX、OC、P1NP、ALP、BAP and OPG,which is better than Insulin glargine combined with ZOL.