利拉鲁肽对2型糖尿病合并肥胖患者胰岛素抵抗的作用及对血清胰高血糖素样肽1的影响  

Effect of liraglutide on insulin resistance and serum glucagon-like peptide-1 in the patients with type 2 diabetes mellitus combined with obesity

作　　者：王荣 徐碧莹 王丽萍[2] WANG Rong;XU Biying;WANG Liping(Department of Pharmacy,Suzhou Science and Technology City Hospital Affiliated to Nanjing Medical University,Jiangsu Suzhou 215000,China;Department of Endocrinology,Suzhou Science and Technology City Hospital Affiliated to Nanjing Medical University,Jiangsu Suzhou 215000,China)

机构地区：[1]南京医科大学附属苏州科技城医院药学部,江苏苏州215000 [2]南京医科大学附属苏州科技城医院内分泌科,江苏苏州215000

出　　处：《药学服务与研究》2021年第4期270-273,共4页Pharmaceutical Care and Research

摘　　要：目的:探讨利拉鲁肽对2型糖尿病合并肥胖患者胰岛素抵抗的作用及对血清胰高血糖素样肽1(glucagon like peptide-1,GLP-1)的影响。方法:选取于2019年在南京医科大学附属苏州科技城医院就诊的76例2型糖尿病合并肥胖患者为研究对象,采用随机数字表法分为对照组和观察组,每组38例。对照组患者采取常规降糖治疗,观察组在常规降糖治疗的基础上加用利拉鲁肽治疗。两组患者均连续治疗12周,观察患者治疗前后的空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2 h postprandial blood glucose,2h-PG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、空腹胰岛素(fasting insulin)、体重指数(body mass index,BMI)、胰岛素抵抗指数(HOMA insulin resistance index,HOMA-IR)、胰岛素分泌指数(HOMA insulin secretion index,HOMA-β)以及血清GLP-1水平变化。比较并记录两组患者的治疗有效率和药品不良反应(adverse drug reactions,ADRs)。结果:观察组总有效率优于对照组(P<0.05);治疗后两组患者的FPG、2h-PG、HbA1c、空腹胰岛素以及BMI均下降,且观察组各临床指标下降更显著(P<0.05);治疗后两组患者的HOMA-IR均下降、HOMA-β均上升,且观察组两项指标的下降和上升幅度较对照组更显著(P<0.05)。治疗后两组患者的血清GLP-1水平较治疗前均上升,且观察组上升更显著(P<0.05)。两组患者治疗期间未发生严重胃肠道反应或严重低血糖事件,ADRs发生率比较无显著差异(P>0.05)。结论:与常规降糖药比较,利拉鲁肽对治疗2型糖尿病合并肥胖患者在体重减轻、改善胰岛素分泌以及调节血清GLP-1水平方面更具优势。Objective:To investigate the effect of liraglutide on insulin resistance and serum glucagon-like peptide-1(GLP-1)in the patients with type 2 diabetes mellitus complicated with obesity.Methods:A total of 76 patients with type 2 diabetes mellitus complicated with obesity who were admitted to the Suzhou Science and Technology City Hospital Affiliated to Nanjing Medical University in 2019 were selected as research subjects,and were randomly divided into the control group and the observation group,each consisting of 38 patients.The patients in the control group received conventional hypoglycemic therapy,while the patients in the observation group were treated with liraglutide on the basis of conventional therapy,both with a treatment of 12 successive weeks.Changes in fasting blood glucose(FBG),2 h postprandial blood glucose(2h-PG),glycosylated hemoglobin(HbA1c),fasting insulin,body mass index(BMI),HOMA insulin resistance index(HOMA-IR),HOMA insulin secretion index(HOMA-β)and serum glucagon like peptide-1(GLP-1)were closely observed before and after treatment.Effective rates and adverse drug reactions(ADRs)were recorded and compared between the 2 groups.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the levels of FPG,2h-PG,HbA1c,fasting insulin and BMI in the 2 groups all decreased,with the clinical indexes of the patients in the observation group decreasing more significantly(P<0.05).Following treatment,the level of HOMA-IR decreased while the level of HOMA-βincreased in both groups,with the decreasing and increasing ranges of the observation group being more prominent than those of the control group(P<0.05).The serum GLP-1 levels of the two groups all increased after treatment,with the GLP-1 level in the observation group increasing more significantly(P<0.05).No serious gastrointestinal or hypoglycemia reactions occurred in the 2 groups during treatment,and no significant differences could be seen in ADRs,when comparisons were made between

关 键 词：利拉鲁肽 糖尿病 2型 肥胖 胰岛素抵抗 胰高血糖素样肽1 

分 类 号：R977.15[医药卫生—药品]