利拉鲁肽改善2型糖尿病胰岛β细胞功能的观察  

Observation of Liraglutide's Effect on Function of Pancreatic Isletsβ-Cell in Type 2 Diabetes

作　　者：常宇 桂莉 李若楠 CHANG Yu;GUI Li;LI Ruonan(Department of Endocrinology,The Third People’s Hospital of Yunnan Province,Kunming Yunnan 650011,China)

机构地区：[1]云南省第三人民医院内分泌科,云南昆明650011

出　　处：《昆明医科大学学报》2025年第2期134-140,共7页Journal of Kunming Medical University

基　　金：云南省教育厅科学研究基金(2020J0617)。

摘　　要：目的观察GLP-1受体激动剂利拉鲁肽对初诊断2型糖尿病患者β细胞功能的影响。方法选择2020年3月至2021年3月在云南省第三人民医院内分泌科收治入院的新诊断2型糖尿病患者,随机分为试验组及对照组,试验组使用GLP-1受体激动剂利拉鲁肽治疗6月,对照组使用非GLP-1受体激动剂治疗6月(一联或二联方案)。观察和检测治疗前及治疗后3月、6月体重、BMI、FPG、2hPG、HbA1c、FINS、FC-P、HOMA-IR、HOMA-β的变化。结果92例患者纳入临床观察(试验组45例,对照组47例),与基线相比,治疗3月、6月后两组患者FPG、2hPG、HbA1c均显著下降(P<0.01),FINS、HOMA-IR、HOMA-β优于治疗前(P<0.05),试验组BMI下降(P<0.05),而对照组略有上升,但差异无统计学意义(P<0.05)。与对照组相比,治疗6月后试验组较基线FPG、2hPG降幅更大,差异具有统计学意义(P<0.05);HbA1c有一定下降,差异无统计学意义(P>0.05)。治疗3月、6月试验组FC-P均优于治疗前(P<0.05),而对照组直到治疗6月结束时FCP才优于治疗前(P<0.05)。结论初诊断2型糖尿病尽早使用GLP-1类似物治疗较非GLP-1类似物方案可以有更优的修复β细胞功能作用、减轻体重、有效改善胰岛素抵抗。Objective To observe the effect of the GLP-1 receptor agonist liraglutide onβ-cell function in patients newly diagnosed with type 2 diabetes patients.Methods Type 2 diabetes patients diagnosed between March 2020 and March 2021 in the Endocrinology Department of Yunnan Provincial Third People's Hospital were recruited and randomly divided into an experimental group and a control group.The experimental group was treated with liraglutide,a GLP-1 receptor agonist,for 6 months,while the control group received treatment with nonGLP-1 receptor agonists for 6 months(monotherapy or dual therapy).Changes in Weight,BMI,FPG,PG,HbA1c,FINS,FC-P,HOMA-IR,and HOMA-βlevels were observed and measured before treatment and at 3 and 6 months after treatment.Results A total of 92 patients were included in the clinical observation(45 in the experimental group and 47 in the control group).Compared to baseline,both groups showed significant reductions in FPG,2hPG,and HbA1c at 3 and 6 months after treatment(P<0.01).FINS,HOMA-IR,and HOMA-βimproved compared to pre-treatment levels(P<0.05).BMI decreased in the experimental group(P<0.05),while it slightly increased in the control group,but the difference was not statistically significant(P>0.05).Compared to the control group,the experimental group showed a greater reduction in FPG and 2hPG from baseline after 6 months of treatment,with statistically significant differences(P<0.05).HbA1c showed a certain decrease,but the difference was not statistically significant(P>0.05).FC-P in the experimental group was superior to pre-treatment levels at both 3 and 6 months(P<0.05),while in the control group,FC-P was only improved at the end of 6 months of treatment(P<0.05).Conclusion Early use of GLP-1 analogs in the treatment of newly diagnosed type 2 diabetes,as opposed to non-GLP-1 analog regimens,can lead to better restoration ofβ-cell function,weight reduction,and effective improvment of insulin resistance.

关 键 词：2型糖尿病 初诊断 利拉鲁肽 Β细胞功能 

分 类 号：R587.1[医药卫生—内分泌]