骨化三醇联合二甲双胍对腹型肥胖2型糖尿病早期肾病的影响  

Clinical Efficacy of Calcitriol Combined with Metformin on Early Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients with Abdominal Obesity

作　　者：陈娇月[1] 山秀杰[1] 刘敏[1] 刘晓燕[1] 宋娜[1] 何建秋[1] 王英南[1] 韩桂艳[1] CHEN Jiaoyue;SHAN Xiujie;LIU Min(The Affiliated Hospital of Chengde Medical University, Hebei Chengde 067000, China)

机构地区：[1]承德医学院附属医院,河北承德067000

出　　处：《河北医学》2020年第4期602-605,共4页Hebei Medicine

基　　金：河北省承德市科技支撑计划项目,(编号:201606A063)。

摘　　要：目的:探讨骨化三醇联合二甲双胍治疗腹型肥胖2型糖尿病(T2DM)早期肾病患者的临床疗效及机制。方法:选取腹型肥胖早期2型糖尿病肾病患者80例,按照分层随机分组法分为观察组和对照组,每组40例。观察组给予骨化三醇联合二甲双胍治疗,对照组单纯给予二甲双胍治疗。比较两组患者治疗前后腰围、体质指数(BMI)、空腹血糖(FPG)、血钙(Ca)、血磷(P)、糖化血红蛋白(HbAlc)、瘦素(LP)、脂联素(ADP)、尿微量白蛋白/肌酐值(ACR)及血清25-(OH)D3水平。采用Pearson相关性分析血清25-(OH)D3水平与ACR的相关性。结果:与治疗前比较,治疗后两组患者的腰围、BMI、FPG、HbAlc、LP和ACR均明显降低,25-(OH)D3和ADP明显升高,差异有统计学意义(P<0.05)。与对照组比较,观察组患者腰围、BMI、FPG、HbAlc、LP和ACR均明显降低,25-(OH)D3和ADP水平明显升高(P<0.05)。结论:对腹型肥胖T2DM患者早期联合应用骨化三醇、二甲双胍治疗能升高患者25-(OH)D3水平,减少尿蛋白,其可能机制与调节ADP、LP水平有关。Objective:To investigate the clinical efficacy and mechanism of calcitriol combined with metformin in the treatment of type 2 diabetes mellitus(T2DM)patients with abdominal obesity and early diabetic nephropathy(EDN).Methods:80 T2DM patients with abdominal obesity and EDN were selected and divided into observation group and control group according to the random number table method,40 patients in each group.The observation group was treated with calcitriol combined with metformin,while the control group was treated with metformin.Waistline,body mass index,fasting plasma glucose,calcium,phosphorus,glycosylated hemoglobin(HbAlc),leptin(LP),adiponectin(ADP),urinary microalbumin/creatinine(ACR)and 25-(OH)D3 were compared between the two groups before and after treatment.Pearson corelation analysis was used to analyze the correlation between serum 25-(OH)D3 level and ACR.Results:Waistline,BMI,FPG,HbAlc,LP and ACR were significantly decreased in the two groups after treatment,and 25-(OH)D3 and ADP were significantly increased(P<0.05).Compared with the control group,waistline,BMI,FPG,HbAlc,LP and ACR were significantly decreased,while 25-(OH)D3 and ADP were significantly increased in the observation group(P<0.05).Conclusion:Early combination of calcitriol and metformin in T2DM patients with abdominal obesity can increase the level of 25-(OH)D3 and reduce urinary protein,which may be related to the regulation of ADP and LP levels。

关 键 词：2型糖尿病 骨化三醇 二甲双胍 

分 类 号：R58[医药卫生—内分泌]