利拉鲁肽对超重/肥胖2型糖尿病患者内脏脂肪、体脂及血糖控制的影响分析

Effect of Liraglutide on visceral fat, body fat and blood glucose control in overweight/obesity petients with type 2 diabetes mellitus

目的探究利拉鲁肽对超重/肥胖2型糖尿病患者内脏脂肪、体脂及血糖控制的影响,以期对临床制订防治对策提供指导。方法选择2016年5月至2018年5月本院收治的144例超重/肥胖2型糖尿病患者为研究对象,采用简单随机法将入选患者分为研究组和对照组,每组各72例。对照组患者予以胰岛素联合二甲双胍治疗,研究组患者在对照组治疗基础上予以利拉鲁肽治疗。比较两组患者治疗前后心外膜脂肪组织(epicardial adipose tissue,EAT)厚度、肝脏脂肪含量(liver fat content,LFC)、胰岛素用量、血糖达标所需天数、体重、体质指数(body mass index,BMI)、不良反应发生情况及糖化血红蛋白(glycated hemoglobin A_(1c),HbA_(1c))、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)水平。结果治疗后,两组患者EAT厚度均显著小于本组治疗前(P_均<0.05),LFC及TC、TG、LDL-C水平均显著低于本组治疗前(P_均<0.05),HDL-C水平均显著高于本组治疗前(P_均<0.05);研究组患者治疗后EAT厚度显著小于对照组(P <0.05),LFC及HbA1c、TC、TG、LDL-C水平均显著低于对照组(P_均<0.05),HDL-C水平显著高于对照组(P_均<0.05)。研究组患者胰岛素用量显著少于对照组(P <0.05),血糖达标所需天数显著短于对照组(P <0.05)。研究组患者治疗后体重和BMI均显著低于本组治疗前和对照组(P_均<0.05)。对照组患者治疗前后体重和BMI比较均无显著差异(P_均> 0.05)。治疗后,研究组患者不良反应发生率显著低于对照组(P <0.05)。结论对于超重/肥胖的2型糖尿病患者,利拉鲁肽具有良好的减重、调脂作用,且对血糖控制更为理想,值得临床推广应用。

Objective To investigate the effects of Liraglutide on visceral fat, body fat and glycemic control in overweight/obesity patients with type 2 diabetes mellitus(T2 DM), in order to provide guidance for clinical development of prevention and treatment strategies. Method 144 overweight/obesity patients with T2 DM admitted to our hospital from May 2016 to May 2018 were randomly divided into control group and study group, 72 cases in each group. Control group patients were treated with Insulin combined with Metformin, and study group patients were treated with Liraglutide on the basis of control group. The thickness of epicardial adipose tissue(EAT), liver fat content(LFC), insulin dosage, days needed for blood glucose to reach the standard, body weight, body mass index(BMI), adverse reactions, glycated hemoglobin A1c(HbA1c), total cholesterol(TC), triglyceride(TG), high density lipoprotein-cholesterol(HDL-C), low density lipoprotein-cholesterol(LDL-C) levels were compared between the two groups before and after treatment. Result After treatment, EAT thickness in both groups were signi?cantly lower than that before treatment(Pall< 0.05), LFC, TC, TG and LDL-C levels were signi?cantly lower than those before treatment(Pall< 0.05), HDL-C levels were signi?cantly higher than those before treatment(Pall< 0.05). After treatment, EAT thickness in study group was signi?cantly lower than that in control group(P < 0.05), the LFC, HbA1c, TC, TG and LDL-C levels were signi?cantly lower than those in control group(Pall< 0.05), the HDL-C level was signi?cantly higher than that in control group(P < 0.05). The insulin dosage of study group was signi?cantly less than that in control group(P < 0.05), and the days needed for blood glucose to reach the standard were signi?cantly shorter than those in control group(P < 0.05). After treatment, the body weight and BMI of study group were signi?cantly lower than those of before treatment and control group(Pall< 0.05). There were no signi?cant differences in body weight and BMI of control group before and after treatment(Pall> 0.05). After treatment, the incidence of adverse reactions in study group was signi?cantly lower than that in control group(P < 0.05). Conclusion For overweight/obesity patients with T2 DM, Liraglutide has good effects on weight loss and lipid regulation, and has better blood sugar control, which is worthy of clinical application.