GLP-1类似物联合二甲双胍对超重或肥胖型2型糖尿病患者血浆内脂素、脂联素水平的影响  

The Effect of GLP-1 Analogue Combined with Metformin on Plasma Visfatin and Adiponectin Levels in Overweight or Obese Patients with Type 2 Diabetes

作　　者：王卫东[1] 刘长梅[2] WANG Wei-dong;LIU Chang-mei(Binzhou Medical College,Binzhou,Shandong Province,256603 China;Department of Endocrinology,Affiliated Hospital of Binzhou Medical College,Binzhou,Shandong Province,256603 China)

机构地区：[1]滨州医学院,山东滨州256603 [2]滨州医学院附属医院内分泌科,山东滨州256603

出　　处：《糖尿病新世界》2020年第19期28-31,共4页Diabetes New World Magazine

摘　　要：目的观察GLP-1类似物联合二甲双胍对超重或肥胖型T2DM患者血浆内脂素、脂联素水平的影响。方法选取该院2019年5月—2020年3月确诊的超重或肥胖型T2DM患者60例,均符合纳入排除标准(年龄在18~70岁)的超重或肥胖型T2DM患者60例(口服二甲双胍血糖不达标,糖化血红蛋白≥7%,BMI≥25 kg/m^2)。采用开放、单中心的随机对照试验,将超重或肥胖性的T2DM患者随机分为观察组30例及对照组30例。观察组在二甲双胍的基础上给予GLP-1类似物,对照组在二甲双胍的基础上给予格列美脲。检测治疗前后两组空腹血糖、餐后血糖、糖化血红蛋白、内脂素、脂联素、BMI、血脂水平,对低血糖发生等严重不良事件进行比较。结果较治疗前,观察组和对照组超重或肥胖型T2DM患者糖化血红蛋白明显下降,差异有统计学意义(P<0.05),治疗后观察组(6.15±1.37)%与对照组(8.75±1.08)%相比,差异有统计学意义(P<0.05)。与治疗前相比,观察组血浆脂联素明显升高[(7.41±3.08)μg/L vs(10.35±3.49)μg/L],血浆内脂素明显降低[(11.13±4.47)mg/L vs(7.96±4.32)mg/L],治疗前后差异有统计学意义(P<0.05);对照组治疗前后血浆脂联素[(7.39±3.02)μg/L vs(7.90±2.85)μg/L]、内脂素[(10.99±4.73)mg/L vs(10.31±4.42)mg/L],差异无统计学意义(P>0.05)。治疗后观察组与对照组血浆脂联素、内脂素相比差异有统计学意义(P<0.05)。结论GLP-1类似物联合二甲双胍能使超重或肥胖型T2DM患者糖化血红蛋白达标,能使血浆脂联素明显升高,血浆内脂素明显降低,可能有预防糖尿病动脉粥样硬化的形成,预防糖尿病大血管并发症的作用。Objective To observe the effect of GLP-1 analogues combined with metformin on plasma visfatin and adiponectin levels in overweight or obese T2DM patients.Methods A total of 60 patients with overweight or obese T2DM diagnosed in the hospital from May 2019 to March 2020 were selected,and 60 patients with overweight or obese T2DM who met the inclusion and exclusion criteria(aged 18-70)were selected(oral metformin blood glucose)not up to standard,glycosylated hemoglobin≥7%,BMI≥25 kg/m^2.Using an open,single-center randomized controlled trial,the overweight or obese T2DM patients were randomly divided into an observation group of 30 cases and a control group of 30 cases.The observation group was given GLP-1 analogs on the basis of metformin,and the control group was given glimepiride on the basis of metformin.The fasting blood glucose,postprandial blood glucose,glycosylated hemoglobin,visfatin,adiponectin,BMI,blood lipid levels were detected before and after treatment,and the serious adverse events such as hypoglycemia were compared.Results Compared with before treatment,the glycated hemoglobin of overweight or obese T2DM patients in the observation group and the control group decreased significantly,and the difference was statistically significant(P<0.05).After treatment,the observation group(6.15±1.37)%and the control group(8.75±1.08)%.In comparison,the difference was statistically significant(P<0.05).Compared with before treatment,plasma adiponectin in the observation group was significantly increased[(7.41±3.08)μg/L vs(10.35±3.49)μg/L],and plasma visfatin was significantly decreased[(11.13±4.47)mg/L vs(7.96±4.32)mg/L],the difference before and after treatment was statistically significant(P<0.05);plasma adiponectin before and after treatment in the control group[(7.39±3.02)μg/L vs(7.90±2.85)μg/L],Visfatin[(10.99±4.73)mg/L vs(10.31±4.42)mg/L],the difference was not statistically significant(P>0.05).After treatment,the observation group and the control group had significant differences in plasma ad

关 键 词：GLP-1类似物 超重或肥胖型2型糖尿病 二甲双胍 血浆内脂素 血浆脂联素 

分 类 号：R587.1[医药卫生—内分泌]