磷酸西格列汀联合利拉鲁肽和骨化三醇对T2DM合并骨质疏松患者糖脂代谢及骨代谢的影响  

Effects of selegiline phosphate combined with liraglutide and osteoporotic triol on glucolipid metabolism and PINP and S-CTX levels in patients with T2DM combined with osteoporosis

作　　者：张璐[1] 张光辉 孙凌雁 Zhang Lu;Zhang Guanghui;Sun Lingyan(Department of Pharmacy,Yantai Yantaishan Hospital,Yantai 264008,China;Department of Orthopedic,People’s Hospital of Zhaoyuan City,Zhaoyuan 264008,China)

机构地区：[1]烟台市烟台山医院药剂科,烟台264008 [2]招远市人民医院骨科,烟台265499

出　　处：《中华内分泌外科杂志》2022年第5期600-604,共5页Chinese Journal of Endocrine Surgery

基　　金：山东半岛国家自主创新示范区发展建设资金项目(ZCQ19206)。

摘　　要：目的探讨磷酸西格列汀联合利拉鲁肽和骨化三醇治疗2型糖尿病(type 2 diabetes mellitus,T2DM)合并骨质疏松(osteoporosis,OP)对患者糖脂代谢、骨密度、骨代谢的影响。方法设计前瞻性随机对照试验,选取烟台山医院门诊2020年1月至2021年8月收治的130例T2DM合并骨质疏松患者作为研究对象,根据预就诊序号按照随机数字表法进行预分组。对照组给予利拉鲁肽和骨化三醇联合治疗,观察组采用磷酸西格列汀联合利拉鲁肽和骨化三醇治疗,各65例,2组均连续治疗3个月。检测对比2组治疗前、治疗3个月后糖脂代谢[糖化血红蛋白(HAb1c)、三酰甘油(TG)、空腹血糖(FBG)、总胆固醇(TC)、餐后2 h血糖(2hPG)、高密度及低密度脂蛋白胆固醇(HDL-C、LDL-C)]、骨密度、骨代谢[骨钙素(OC)、25-羟基维生素[25(OH)D]、Ⅰ型胶原C末端肽(S-CTX)、I型前胶原氨基端肽原(PINP)、骨特异性碱性磷酸酶(b-ALP)]水平变化情况,并对比2组用药不良反应及疗效。结果治疗3个月后观察组FBG(7.48±1.02)mmol/L、TG(2.01±0.31)mmol/L、PINP(43.72±4.86)ng/ml、HAb1c(7.43±0.65)%、S-CTX(0.27±0.09)ng/ml、2hPG(9.08±1.34)mmol/L、LDL-C(2.58±0.27)mmol/L,低于对照组(7.86±0.97)mmol/L、(2.29±0.34)mmol/L、(46.55±4.19)ng/ml、(7.81±0.62)%、(0.32±0.10)ng/ml、(10.52±1.41)mmol/L、(2.89±0.31)mmol/L(t=2.177、5.968、3.556、3.481、2.996、5.968、6.080,P<0.05)。治疗3个月后观察组股骨粗隆、腰椎正位、股骨颈和前臂4个部位骨密度(0.76±0.09)、(0.75±0.10)、(0.76±0.11)和(0.75±0.09)g/cm3及OC(20.87±2.33)μg/L、b-ALP(19.70±2.35)U/L高于对照组(0.70±0.10)、(0.68±0.09)、(0.69±0.10)和(0.70±0.10)g/cm3及(18.45±3.66)μg/L、(18.09±2.14)U/L(t=3.596、4.195、3.796、2.996、4.497、4.084,P<0.05)。观察组总有效率96.92%高于对照组84.61%(χ^(2)=5.876,P<0.05);2组不良反应发生率比较,差异无统计学意义(χ^(2)=0.000,P>0.05)。结论磷酸西格列汀联合利拉鲁肽和骨化三�Objective To investigate the effects of selegiline phosphate combined with liraglutide and osteopontin on glucolipid metabolism,bone mineral density and bone metabolism in patients with type 2 diabetes mellitus(T2DM)combined with osteoporosis(OP).Methods A prospective randomized controlled trial was designed.130 patients with T2DM combined with OP admitted to the outpatient clinic of Yantai Yantaishan Hospital from Jan.2020 to Aug.2021 were selected as study subjects and pregrouped according to the pre-visit serial number according to the random number table method,65 cases each.The control group weregiven liraglutide and osteopontin combination therapy,and the observation group were treated with sitagliptin phosphate combined with liraglutide and osteopontin,and both groups were treated continuously for 3 months.The tests compared the glycolipid metabolism[glycosylated hemoglobin(HAb1c),triacylglycerol(TG),fasting blood glucose(FBG),total cholesterol(TC),2h postprandial glucose(2hPG),high-density and low-density lipoprotein cholesterol(HDL-C,LDL-C)],bone density[4 sites of femoral trochanter,lumbar orthostyle,femoral neck,forearm],before and after 3 months of treatment in the 2 groups.Changes in bone metabolism osteocalcin(OC),type I collagen C-terminal peptide(S-CTX),25-hydroxyvitamin[25(OH)D],type I procollagen amino-terminal peptidogen(PINP),and bone-specific alkaline phosphatase(b-ALP)]levels were detected,and the adverse effects and efficacy of drug administration in the 2 groups were compared.Results After 3 months of treatment,FBG(7.48±1.02)mmol/L,TG(2.01±0.31)mmol/L,PINP(43.72±4.86)ng/ml,HAb1c(7.43±0.65)%,S-CTX(0.27±0.09)ng/ml,2hPG(9.08±1.34)mmol/L in the observation group,LDL-C(2.58±0.27)mmol/L were lower than those in the control group(7.86±0.97)mmol/L,(2.29±0.34)mmol/L,(46.55±4.19)ng/ml,(7.81±0.62)%,(0.32±0.10)ng/ml,(10.52±1.41)mmol/L,(2.89±0.31)mmol/L(t=2.177,5.968,3.556,3.481,2.996,5.968,6.080,P<0.05);after 3 months of treatment,the bone density of each site in the observation group wa

关 键 词：血糖 2型糖尿病 骨质疏松 骨代谢 骨密度 西格列汀 

分 类 号：R580[医药卫生—内分泌]