吡格列酮二甲双胍联合运动康复对超重或肥胖2型糖尿病患者糖脂代谢和胰岛功能的影响  

Effects of Pioglitazone Metformin Combined with Exercise Rehabilitation on Glucose and Lipid Metabolism and Islet Function in Overweight or Obese Patients with Type 2 Diabetes Mellitus

作　　者：郑欣[1] 戚艳艳[1] 毕丽娜[1] 胡苏 赵丹 ZHENG Xin;QI Yan-yan;BILi-na;HU Su;ZHAO Dan(Department of Endocrine,China Rehabilitation Rescarch Center/Beijing Bo'ai hospital,Beijing,100068,China)

机构地区：[1]中国康复研究中心/北京博爱医院内分泌科,北京100068

出　　处：《现代生物医学进展》2021年第7期1257-1260,1238,共5页Progress in Modern Biomedicine

基　　金：中央级公益性科研院所基本科研业务费专项资金项目(2014CZ-26);北京市自然科学基金项目(7162049)。

摘　　要：目的:探讨吡格列酮二甲双胍联合运动康复对超重或肥胖2型糖尿病患者糖脂代谢和胰岛功能的影响。方法:选取经一般生活方式干预血糖控制不佳的超重或肥胖2型糖尿病患者85例,按照干预方式分为药物组(40例)和联合组(45例),两组均给予糖尿病教育和饮食指导,药物组给予吡格列酮二甲双胍片口服,联合组在药物组基础上给予运动康复,分别于干预前及干预3个月后,计算体质量指数(BMI),测定空腹血糖(FPG)、餐后2 h血糖(2hPG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、甘油三酯(TG)、游离脂肪酸(FFA)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS),并计算胰岛素抵抗指数(HOMA-IR)和β细胞功能指数(HOMA-β)。结果:两组患者干预3个月后的FPG、2hPG、HBA1c、FINS、HOMA-IR、TC、LDL-C、TG、FFA均较干预前下降,HOMA-β、HDL-C较干预前升高(P<0.05),联合组干预3个月后的BMI较干预前下降(P<0.05)。干预3个月后,联合组的BMI、2hPG、HBA1c、FINS、HOMA-IR、TC、LDL-C、TG、FFA均低于药物组(P<0.05)。结论:吡格列酮二甲双胍联合运动康复可改善超重或肥胖2型糖尿病患者的糖脂代谢紊乱,并具有额外的减重获益,且能够改善患者的胰岛功能。Objective:To investigate the effect of pioglitazone metformin combined with exercise rehabilitation on glucose and lipid metabolism and islet function in overweight or obese patients with type 2 diabetes mellitus.Methods:A total of 85 type 2 diabetic patients with overweight or obesity who had poor blood glucose control under lifestyle intervention were included in the study.They were divided into drug group(40 cases)and combined group(45 cases)according to intervention methods.Both groups were given diabetes education and dietary guidance.The drug group was given pioglitazone metformin orally,and the combined group was given exercise rehabilitation based on the basis of drug group.Before and 3 months after intervention,the body mass index(BMI),fasting plasma glucose(FPG),2 hour post prandial plasma glucose(2 hPG),total cholesterol(TC),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),triglyceride(TG),free fatty acid(FFA),glycated hemoglobin(HbA1 c),and fasting insulin(FINS)were measured,and the insulin resistance index(HOMA-IR)andβcell function index(HOMA-β)were measured.Results:3 months after intervention,the FPG,2 hPG,HBA1 c,FINS,HOMA-IR,TC,LDL-C,TG and FFA of the two groups were lower than those before intervention,and HOMA-βand HDL-C were higher than those before intervention(P<0.05).BMI of the combined group decreased compared with before intervention(P<0.05).3 months after intervention,BMI,2 hPG,HBA1 c,FINS,HOMA-IR,TC,LDL-C,TG,FFA of the combined group were lower than those of the drug group(P<0.05).Conclusion:Pioglitazone metformin combined with exercise rehabilitation can improve the disorder of glucose and lipid metabolism in overweight or obese patients with type 2 diabetes mellitus,and has additional weight loss benefits,as well as improve the islet function of patients.

关 键 词：运动康复 吡格列酮 二甲双胍 2型糖尿病 超重 肥胖 血糖 血脂 胰岛功能 

分 类 号：R587.2[医药卫生—内分泌]