利格列汀对2型糖尿病合并肥胖患者糖脂代谢指标及胰岛β细胞分泌功能的影响  

Effects of Linagliptin on glucose and lipid metabolism and isletβcell secretion in patients with type 2 diabetes mellitus combined obesity

作　　者：那彩霞 何一飞 赵静 Na Caixia;He Yifei;Zhao Jing(Department of Endocrinology,Xiaoyi People′s Hospital,Xiaoyi 032300,China)

机构地区：[1]孝义市人民医院内分泌科,山西孝义032300

出　　处：《中国临床实用医学》2020年第2期37-40,共4页China Clinical Practical Medicine

摘　　要：目的:探讨利格列汀对2型糖尿病(T2DM)合并肥胖患者糖脂代谢指标及胰岛β细胞分泌功能的影响。方法:选取2015年2月至2019年6月孝义市人民医院内分泌科收治的130例T2DM合并肥胖患者,男77例,女53例,年龄(59.42±5.64)岁,年龄范围为38~77岁,采用随机数表法将患者随机分为联合治疗组和单药治疗组,每组65例。两组患者入院后辅以对症支持治疗,联合治疗组行格列美脲片联合利格列汀片治疗,单药治疗组使用格列美脲片治疗。连续治疗3个月后,比较两组血脂指标水平[甘油三酯、总胆固醇、高密度脂蛋白胆固醇水平(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、血糖指标水平[糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(2 hPG)]、胰岛素功能指标[胰岛素抵抗指数(HOMA-IR)、胰岛素β细胞功能指数(HOMA-β)]、不良反应发生情况。结果:治疗3个月后,联合治疗组甘油三酯[(1.51±0.64)mmol/L]、总胆固醇[(3.98±0.34)mmol/L]、LDL-C[(2.03±0.19)mmol/L]低于单药治疗组[(2.42±0.32)mmol/L、(4.46±0.22)mmol/L、(2.42±0.16)mmol/L];HDL-C[(1.33±0.22)mmol/L]高于单药治疗组[(0.95±0.14)mmol/L],HbA1c[(7.18±0.16)%]、FBG[(6.39±0.41)mmol/L]、2 hPG[(8.07±1.42)mmol/L]低于单药治疗组[(7.95±0.18)%、(6.99±0.27)mmol/L、(9.42±1.01)mmol/L];HOMA-IR(1.96±0.24)低于单药治疗组(2.99±0.34)、HOMA-β(10.35±1.50)高于单药治疗组(8.79±1.27),差异有统计学意义(P<0.05)。联合治疗组不良反应发生率[6.2%(4/65)]与单药治疗组[10.8%(7/65)]比较,差异无统计学意义(P=0.344)。结论:利格列汀联合格列美脲片治疗T2DM合并肥胖患者,可有效改善糖脂代谢功能,增强胰岛β细胞分泌功能,改善胰岛素抵抗,安全性较高,值得在临床上推广应用。Objective To investigate the effects of Linagliptin on glucose and lipid metabolism and isletβcell secretion in patients with type 2 diabetes mellitus(T2DM)and obesity.Methods A retrospective study was performed on 130 cases of T2DM patients with obesity who were admitted in the department of Endocrinology,Xiaoyi People′s Hospital from February 2015 to June 2019.There were 77 males and 53 females,aged(59.42±5.64)years old,ranging from 38 to 77 years.Patients were randomly divided into the combination treatment group and monotherapy group,with 65 cases in each group.After admission,the two groups of patients were supplemented with symptomatic supportive treatment.The combination treatment group of patients were treated with glimepiride tablets combined Linagliptin tablets,the monotherapy group of patients were treated with glimepiride tablets.After three months of continuous treatment,the levels of serum lipid index[triglyceride,total cholesterol,high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C)],serum glucose index[glycated hemoglobin Al(HbAlc),fasting blood glucose(FBG),2-hour postprandial blood glucose(2 hPG)],insulin function index[hemoglobin model assessment of insulin resistance(HOMA-IR),homeostasis model assessment index ofβcell(HOMA-β)and adverse reactions were compared between the two groups.Results After 3 months of treatment,the triglyceride[(1.51±0.64)mmol/L],total cholesterol[(3.98±0.34)mmol/L]and LDL-C[(2.03±0.19)mmol/L]]in the combination treatment group were lower than[(2.42±0.32)mmol/L,(4.46±0.22)mmol/L,(2.42±0.16)mmol/L]in the monotherapy group;HDL-C[(1.33±0.22)mmol/L]in the combination group was higher than that in the monotherapy group[(0.95±0.14)mmol/L].HbA1c[(7.18±0.16)%],FBG[(6.39±0.41)mmol/L]and 2 hPG[(8.07±1.42)mmol/L]in the combination group were lower than the monotherapy group[(7.95±0.18)%,(6.99±0.27)mmol/L,(9.42±1.01)mmol/L];HOMA-IR(1.96±0.24)in the combination group was lower than that of the monotherapy group(2.99±0.34)and HO

关 键 词：糖尿病 肥胖 利格列汀 糖脂代谢指标 胰岛Β细胞分泌功能 

分 类 号：R587[医药卫生—内分泌] R589[医药卫生—内科学]