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达格列净联合利拉鲁肽强化降糖方案对超重及肥胖T2DM患者胰岛素抵抗及脂代谢的影响

Effects of Dagliliazine Combined with Liraglutide on Insulin Resistance and Lipid Metabolism in Overweight and Obese T2DM Patients
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摘要 目的探究达格列净联合利拉鲁肽强化降糖方案对超重及肥胖2型糖尿病(T2DM)患者胰岛素抵抗(IR)以及脂代谢指标的影响。方法选取2020年8月至2021年8月在本院就诊的超重或肥胖T2DM患者148例,随机分为对照组和观察组,各74例。对照组行利拉鲁肽治疗,观察组则予以达格列净联合利拉鲁肽治疗,两组均持续用药3个月。比较两组治疗前、3个月后患者血糖情况[空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)]、IR[稳态模型IR指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、胰岛素曲线下面积(INSAUC)、血糖下曲线面积(PGAUC)。]、脂代谢[低/高密度脂蛋白胆固醇(L/HDL-C)、总胆固醇(TC)、三酰甘油(TG)]、脂肪相关因子[脂联素(ADP)、游离脂肪酸(FFA)、瘦素(Lep-tin)]、肝肾功能[尿素氮(BUN)、肌酐(Scr)、丙谷转氨酶(ALT)、谷草转氨酶(ALT)]水平的差异性,并评价治疗的安全性。结果3个月后,观察组FPG、2hPG、HbA1c、HOMA-IR、INSAUC、PGAUC、TG、TC、LDL-C、Lep-tin、FFA、BUN、Scr、ALT以及AST均低于对照组(P<0.05),其HOMA-β、LDL-C、ADP均高于对照组(P<0.05)。两组的不良反应发生率分别为10.80%和13.51%,比较无统计学差异(P>0.05)。结论达格列净联合利拉鲁肽治疗超重及肥胖T2DM,能够降低血糖,减轻IR程度,调节血脂代谢,改善脂肪细胞因子,较为安全。 Objective To investigate the effects of Dagliliazine combined with Liraglutide on insulin resistance(IR)and lipid metabolism indexes in overweight and obese patients with type 2 diabetes mellitus(T2DM).Methods 148 overweight or obese T2DM patients admitted to our hospital from August 2020 to August 2021 were selected and randomly divided into control group and observation group,with 74 cases in each group.The control group was treated with liraglutide,while the observation group was treated with dagliagliazine combined with liraglutide.Both groups continued to receive the drug for 3 months.Blood glucose levels[fasting blood glucose(FPG),postprandial 2h blood glucose(2hPG),glycosylated hemoglobin(HbA1c)],IR homeostasis model IR index(HOMA-IR),islet beta cell function index(HOMA-β),insulin area under the curve(INSAUC)and subglycemic curve area between the two groups were compared before treatment and 3 months after treatment(PGAUC).,lipid metabolism[low/high density lipoprotein cholesterol(L/HDL-C),total cholesterol(TC),triacylglycerol(TG)],adipose-related factors[adiponectin(ADP),free fatty acid(FFA),leptin(Lep-tin)],liver and kidney function[urea nitrogen(BUN),creatinine(Scr),propyl aminotransferase(ALT),glutamic straw Aminotransferase(ALT)]levels to evaluate the safety of treatment.Results After 3 months,FPG,2hPG,HbA1c,HOMA-IR,INSAUC,PGAUC,TG,TC,LDL-C,leptin,FFA,BUN,Scr,ALT and AST in the observation group were lower than those in the control group(P<0.05).HOMA-β,LDL-C and ADP were higher than those in control group(P<0.05).The incidence of adverse reactions was 10.80%and 13.51%,and there was no statistical difference between the two groups(P>0.05).Conclusion Dagliliazine combined with Liraglutide in the treatment of overweight and obese T2DM can reduce blood sugar,reduce IR level,regulate lipid metabolism and improve adipocytokines,which is relatively safe.
作者 王利 谢骅 高红红 WANG Li;XIE Hua;GAO Hong-hong(The Third People's Hospital of Henan Province,Zhengzhou 450000,Henan Province,China)
出处 《罕少疾病杂志》 2024年第10期133-135,共3页 Journal of Rare and Uncommon Diseases
关键词 2型糖尿病 达格列净 利拉鲁肽 胰岛素抵抗 脂代谢 Type 2 Diabetes Mellitus Dagliazine Liraglutide Insulin Resistance Lipid Metabolism
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