度拉糖肽对2型糖尿病患者骨代谢标志物的影响及其可能机制  

Impacts of dulaglutide on bone metabolic markers in patients with type 2 diabetes mellitus and its possible mechanism

作　　者：张勤凤 李欢 胡婧 乐有晴 张宏武 ZHANG Qinfeng;LI Huan;HU Jing;LE Youqing;ZHANG Hongwu(Department of Endocrinology,Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine,Guangdong,Shenzhen 518104,China)

机构地区：[1]深圳市中西医结合医院内分泌病科,广东深圳518104

出　　处：《中国医药科学》2023年第8期91-93,113,共4页China Medicine And Pharmacy

基　　金：广东省深圳市宝安区科技计划基础研究项目(2019JD196)。

摘　　要：目的探讨度拉糖肽对2型糖尿病患者骨代谢标志物的影响及其可能机制。方法选择深圳市中西医结合医院内分泌病科2020年5月至2021年12月收治的68例2型糖尿病患者,随机数表法分为对照组(n=34)及治疗组(n=34)。对照组予胰岛素及二甲双胍降血糖;治疗组在对照组基础上加度拉糖肽注射液联合降糖。连续治疗12周,比较两组患者治疗前后的空腹血糖(FBG)、糖化血红蛋白(HbA1C)、空腹C肽、体重指数(BMI)及骨代谢标志物[包括β-胶原降解产物(β-CTX)、Ⅰ型胶原羧基前端肽(PINP)、骨钙素(OC)]的变化情况,并比较两组的不良反应发生率。结果68例患者完成12周随访。治疗前,两组患者FBG、HbA1C、空腹C肽、BMI、PINP、OC、β-CTX比较,差异无统计学意义(P>0.05)。治疗后,治疗组患者HbA1C、β-CTX低于对照组,空腹C肽、PINP及OC高于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论度拉糖肽可改善2型糖尿病患者胰岛功能,促进骨形成、抑制骨吸收,这为2型糖尿病合并骨质疏松患者的降糖药物的选择提供有力依据。Objective To investigate the impacts of dulaglutide on bone metabolic markers in patients with type 2 diabetes mellitus(T2DM)and its possible mechanism.Methods A total of 68 patients with T2DM admitted to and treated in the Department of Endocrinology in Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine from May 2020 to December 2021 were selected and divided into the control group(n=34)and the treatment group(n=34)according to the random number table method.The control group was treated with insulin and metformin to reduce blood glucose;while the treatment group was additionally treated with dulaglutide injection based on the treatment in the control group to reduce blood glucose.After continuous treatment for 12 weeks,the changes of fasting blood glucose(FBG),glycosylated hemoglobin(HbA1C),fasting C-peptide,body mass index(BMI)and bone metabolic markers(includingβ-collagen degradation products[β-CTX],typeⅠcollagen carboxylterminal peptide[PINP]and osteocalcin[OC])were compared before and after treatment,and the incidence of adverse reactions(ADRs)was compared between the two groups.Results A total of 68 patients were followed up for 12 weeks.Before treatment,there was no statistically significant difference in FBG,HbA1C,fasting C-peptide,BMI,PINP,OC,β-CTX between the two groups of patients(P>0.05).After treatment,HbA1C andβ-CTX were lower than the control group,while fasting C-peptide,PINP,and OC were higher than the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the total incidence of ADRs between the two groups(P>0.05).Conclusion Dulaglutide can improve pancreatic islet function,promote bone formation,and inhibit bone resorption in patients with T2DM,and it provides a strong basis for the selection of hypoglycemic drugs for patients with T2DM complicated with osteoporosis.

关 键 词：度拉糖肽 2型糖尿病 骨代谢标志物 GLP-1类似物 

分 类 号：R587.1[医药卫生—内分泌]