利拉鲁肽对不同海拔地区糖调节受损肥胖患者血管内皮功能障碍的影响  

Effects of liraglutide on vascular endothelial dysfunction in obese patients with impaired glucose regulation living at different altitudes

作　　者：温智峰[1] 蒲蔚荣[2] 刘香春[2] 苏文博[2] 王文娟[2] 杨晓琴[2] 李志悦[2] 

机构地区：[1]青海省中医院超声科,青海西宁810000 [2]青海省中医院内分泌科,青海西宁810000

出　　处：《中国新药与临床杂志》2016年第8期576-580,共5页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的观察利拉鲁肽对不同海拔地区糖调节受损肥胖患者内皮功能障碍的影响。方法选择经彩色多普勒检查血管内皮功能障碍的糖调节受损肥胖患者98例，按居住地海拔高度分为低海拔（1780～2999米）组（n=52）和高海拔（3000～3719米）组（n=46）。全部患者使用利拉鲁肽（起始剂量0．6mg·d-1，皮下注射）治疗3个月，治疗前后检测血糖，血脂，血压，肝、肾功能等指标，使用全数字化高分辨率彩超测定肱动脉血管内皮依赖性舒张功能（FMD）。结果与治疗前比较，治疗后两组肝、肾功能，空腹血糖，餐后血糖，血脂，血压，腰臀比，糖化血红蛋白和C反应蛋白均有改善趋势．但无显著差异（P〉0．05）；两组空腹胰岛素和稳态胰岛素评价指数水平均显著下降（P〈0．05），且低海拔组较高海拔组下降更为显著（P〈0．05）。治疗后两组FMD均显著高于治疗前（P〈0．05），且低海拔组高于高海拔组（P〈0．05），低海拔组和高海拔组分别有28例（54％）和14例（30％）患者FMD转为正常，两组相比差异显著（P〈0．05）。结论利拉鲁肽对不同海拔地区糖调节受损肥胖患者的血管内皮功能障碍及胰岛素抵抗均有不同程度的改善作用，且对低海拔地区患者改善作用更为显著。AIM To investigate the effects of liraglutide on vascular endothelial dysfunction in obese patients with impaired glucose regulation living at different altitudes. METHODS Nighty-eight obese patients with impaired glucose regulation who were diagnosed as vascular endothelial dysfunction by Color Doppler Ultrasound were enrolled. They were divided by residence altitude into low-altitude group （n = 52, with living altitude 1 780 -2 999 meters） and high-altitude group （n = 46, with living altitude 3 000-3 719 meters）. All patients were treated with liraglutide for 3 mouths. Brachial artery endothelium-dependent flow-mediated dilation （FMD） was measured before and after treatment using full-digital, high-resolution color Doppler ultrasound, as well as the blood glucose, blood lipids, blood pressure, liver and kidney function and other metabolism markers. RESULTS The liver function, kidney function, fasting blood glucose, postprandial blood glucose, blood lipid, blood pressure, waist-hip ratio （WHR）, hemoglobin AI~ （HbAI,.） and C-reactive protein （CRP） in two groups were improved with various degrees after the treatment, but without a significant difference （P 〉 0.05）. Fasting blood insulin （FINS） and homeostatic model estimates of insulin resistance （HOMA-IR） levels in both groups were significantly decreased after the treatment. And the decrease of FINS and HOMA-IR levels in the low-altitude group was significantly more than those in the high altitude group （P 〈 0.05）. Endothelial function FMD in both groups was significantly increased after the treatment （P 〈 0.05）. Moreover, the increase of FMD in the low-altitude group was significantly more than that in the high altitude group （P 〈 0.05）. After the treatment, normalized FMD was observed in 28 patients （53.8%） in the low- altitude group and in 14 patients （30.4%） in the high-altitude group, respectively. Compared with the high-altitude group, there was a significant higher turnover rate of FDM in the

关 键 词：利拉鲁肽 高海拔 葡萄糖代谢障碍 肥胖症 

分 类 号：R179[医药卫生—妇幼卫生保健]