聚乙二醇洛塞那肽与利拉鲁肽治疗肥胖2型糖尿病疗效对比

Polyethylene glycol loxenatide versus liraglutide in treatment of patients with type 2 diabetes mellitus and morbide obesity

目的通过比较聚乙二醇洛塞那肽与利拉鲁肽治疗肥胖2型糖尿病的疗效,为临床治疗该类疾病选择更高效的用药方案。方法选取东南大学医学院附属南京同仁医院2022年1月至2023年10月予以相应治疗的肥胖2型糖尿病患者共136例作为此次试验对象,按照随机数字表法分成68例A组(聚乙二醇洛塞那肽治疗)与68例B组(利拉鲁肽治疗)。比较治疗前后两组肥胖相关指标、治疗前后两组血脂相关指标、治疗前后两组血糖指标以及治疗后不良反应发生率。结果治疗后两组体质量、腰臀比、体质量指数(BMI)和腰围均下降,B组体质量和BMI[分别为(80.31±7.62)kg和(24.13±1.82)kg·m^(-2)]低于A组体质量[分别为(83.65±7.93)kg和BMI(25.34±1.84)kg·m^(-2)](体质量:t=2.504,P=0.014;BMI:t=3.855,P<0.05);治疗后两组甘油三酯(TG)、血清总胆固醇(TC)和低密度脂蛋白(LDL)均下降,高密度脂蛋白胆固醇(HDL-C)上升(均P<0.05);治疗后两组餐后2 h血糖(2 h FBG)、空腹血糖(FBG)、糖化血红蛋白(HbAlc)、胰岛素抵抗指数(HOMA-IR)水平均下降,空腹血糖胰岛素(FINS)、β细胞功能指数(HOMA-β)水平均上升,A组2 h FBG、FBG[分别为(7.86±1.12)mmol·L^(-1)、(6.18±0.71)mmol·L^(-1)]低于B组[分别为2 h FBG(8.72±1.34)mmol·L^(-1)和FBG(7.02±0.62)mmol·L^(-1)](2 h FBG:t=4.061,P<0.05;FBG:t=7.349,P<0.05),A组HOMA-β[(74.62±3.78)%]高于B组[(62.79±3.56)%](t=18.937,P<0.05);两组不良反应发生率比较差异无统计学意义(20.59%vs 25.00%,χ^(2)=0.376,P=0.540)。结论对于肥胖2型糖尿病患者,聚乙二醇洛塞那肽与利拉鲁肽均能有效减轻体质量、调节血脂、降低血糖水平以及增强胰岛β细胞的功能,且安全性相似。然而,在降低体质量方面,利拉鲁肽的效果更为显著,而聚乙二醇洛塞那肽在改善胰岛β细胞功能和降低血糖方面则表现更为出色。

Objective To compare polyethylene glycol loxenatide with liraglutide in treatment of patients suffering from type 2 diabetes mellitus and severe obesity for suggesting a potent treatment protocol for the clinical management of this condition.Methods A total of 136 patients with type 2 diabetes mellitus and severe obesity admitted to Nanjing Tongren Hospital Affiliated to Southeast University School of Medicine from January 2022 to October 2023 were enrolled in this study and divided into two groups using the random number table method.The 68 patients in group A were administered polyethylene glycol loxenatide,while the other 68 in group B received liraglutide.Then the obesity physical-related indexes,lipid indicators,blood glucose indicators and the incidence of adverse reactions were compared between the two groups.Results A reduction in body weight,waist-to-hip ratio,body mass index(BMI)and waist circumference was observed in all patients after treatment,and group B had lower body weight-2((80.31±7.62)kg vs(83.65±7.93)kg)and BMI((24.13±1.82)kg·m vs(25.34±1.84)kg·m^(-2))as compared with group A(body weight t=2.504,P=0.014;BMI t=3.855,P<0.05).A decrease in triglyceride(TG),total cholesterol(TC)and low density lipoprotein(LDL-C),and an increase in high density lipoprotein cholesterol(HDL-C)were observed in all patients after treatment(P<0.05).A decrease in 2-hour postprandial blood glucose(2 h FBG),postprandial blood glucose(FBG),hemoglobin A1c(HbAlc),and homeostasis model assessment of insulin resistance(HOMA-IR),and an increase in fasting insulin(FINS)and HOMAβcell function(HOMA-β)were-1 detected in all patients after treatment,and group A reported a smaller 2 h FBG((7.86±1.12)mmol·L vs(8.72±1.34)mmol·L^(-1))and-1 FBG((6.18±0.71)mmol·L vs(7.02±0.62)mmol·L^(-1)),and larger HOMA-β((74.62±3.78)%vs(62.79±3.56)%)as compared with group B(2 h FBG t=4.061,P<0.05;FBG t=7.349,P<0.05;HOMA-βt=18.937,P<0.05).The adverse reaction rate demonstrated no statistical difference between the two groups(20.59%vs 25.00%,χ^(2)=0.376,P=0.540).Conclusion For patients with type 2 diabetes mellitus and morbide obesity,both polyethylene glycol loxenatide and liraglutide are effective in reducing body weight,controlling blood lipids,lowering blood glucose,as well as enhancing pancreaticβ-cell function,and the safety profile is similar.However,liraglutide is more advantageous in reducing body weight,while polyethylene glycol loxenatide is more effective in improving pancreaticβ-cell function and lowering blood glucose.