司美格鲁肽联合二甲双胍治疗肥胖或超重T2DM的疗效研究

Efficacy of smectide combined with metformin in the treatment of obese or overweight T2DM

·目的:探究司美格鲁肽联合二甲双胍治疗肥胖或超重2型糖尿病(T2DM)临床疗效研究及对骨代谢的影响。方法:选取2020年1月~2023年1月期间我院收治的124例肥胖或超重T2DM患者作为研究对象。按治疗方法的不同,将患者分为对照组(二甲双胍治疗,60例)和观察组(司美格鲁肽联合二甲双胍治疗,64例)。分析比较两组的血糖、血脂、骨密度(BDM)、Ⅰ型前胶原氨基端原肽(PINP)、钙(Ca)、β胶联降解产物(β-CTX)水平、BMI和血尿酸(SUA)、及不良反应。结果:治疗后,两组患者空腹血糖(FBG)、餐后2 h血糖(2 h BG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、收缩压(SBP)、舒张压(DBF)、β-CTX和血尿酸(SUA)水平均明显下降,高密度脂蛋白胆固醇(HDL-C)水平明显上升,且观察组改变幅度更为明显(P<0.001)。治疗后,对照组PINP明显上升,观察组Ca水平明显升高(P<0.05)。治疗后,两组BMI无明显变化(P>0.05);但两组SUA水平均明显下降(P<0.05)。治疗期间,两组不良反应发生率无明显差异(P>0.05)。结论:司美格鲁肽治疗肥胖或超重T2DM患者可有效降糖、调压、降脂,抑制骨吸收、促进骨形成,保护骨代谢。

Objective:To investigate the clinical efficacy of smeglutide combined with metformin in the treatment of obese or overweight typeⅡdiabetes mellitus(T2DM)and its effect on bone metabolism.Method:124 obese or overweight T2DM patients admitted to our hospital from January 2020 to January 2023 were selected as the study subjects.According to different treatment methods,the patients were divided into a control group(60 cases treated with metformin)and an observation group(64 cases treated with smectide combined with metformin).The blood glucose,blood lipids,bone density(BDM),typeⅠprocollagen amino terminal peptide(PINP),calcium(Ca)βGel linked degradation products(β-CTX levels,BMI,blood uric acid(SUA),and adverse reactions were analyzed.Results:After treatment,fasting blood glucose(FBG),2-hour postprandial blood glucose(2hBG),glycated hemoglobin(HbA1c),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),systolic blood pressure(SBP),diastolic blood pressure(DBF)β-The levels of CTX and serum uric acid(SUA)were significantly reduced,while the levels of high-density lipoprotein cholesterol(HDL-C)were significantly increased,and the observed group showed more significant changes(P<0.001).After treatment,PINP in the control group significantly increased,while Ca levels in the observation group significantly increased(P<0.05).After treatment,there was no significant change in BMI between the two groups(P>0.05);However,both groups showed a significant decrease in SUA levels(P<0.05).During the treatment period,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Smegglutide can effectively lower blood sugar,regulate blood pressure,lower blood lipids,inhibit bone resorption,promote bone formation,and protect bone metabolism in the treatment of obese or overweight T2DM patients.