摘要
目的:分析利拉鲁肽与二甲双胍对初发2型糖尿病伴肥胖患者体质情况、代谢和微炎症状态的影响。方法:将55例初发2型糖尿病伴肥胖患者纳入研究,根据治疗方案不同分为观察组(n=30)及对照组(n=25)。对照组接受单纯二甲双胍治疗,观察组接受利拉鲁肽与二甲双胍治疗,检测两组治疗1个疗程后糖脂代谢指标、体质指标及纤溶活性相关指标、微炎症相关信号通路、病情相关指标等水平。结果:观察组治疗后静脉血空腹血糖(FPG)、糖化血红蛋白A1(GHb A1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)值均低于对照组(P<0.05);观察组治疗后腰围、臀围及腰臀比均降低,血栓调节蛋白(TM)值低于对照组而纤溶酶原激活物(t-PA)值高于对照组(P<0.05);观察组治疗后TLR4-NF-κB信号通路及DAG/PKC信号通路的下游TLR4、p-NF-κB p65、DAG、PKC分子蛋白表达量均显著低于对照组(P<0.05);观察组治疗后血清脂联素(APN)、Nesfatin-1、胰岛素敏感指数(ISI)值高于对照组,瘦素(LP)、趋化素(chemerin)、视黄醇结合蛋白4(RBP4)、空腹胰岛素(FINS)值低于对照组(P<0.05)。结论:利拉鲁肽与二甲双胍联合治疗可以显著改善初发2型糖尿病伴肥胖患者的体质状态,优化整体病情并有望改善治疗结局。
Objective： To analyze the effect of liraglutide and metformin on the constitution,metabolism and micro-inflammatory state in newly diagnosed type 2 diabetic mellitus patients with obesity. Methods： A total of 55 cases of newly diagnosed type 2 diabetic mellitus patients with obesity were included for study and divided into observation group（ n = 30） and control group（ n = 25）according to different treatment plans. Control group received metformin treatment alone,observation group received liraglutide and metformin treatment,and levels of glucolipid metabolism indicators,body mass index and fibrinolytic activity-related indicators,microinflammation-related signaling pathways,illness-related indicators,etc of two groups were detected after one course of treatment. Results： FPG,GHb A1 c,TC,TG and LDL-C values in venous blood of observation group after treatment were lower than those of control group（ P〈0. 05）; waistline,hipline and waist-hip ratio of observation group decreased after treatment,TM value was lower than that of control group while t-PA value was higher than that of control group（ P〈0. 05）; TLR4-NF-κB signaling pathway and DAG / PKC signaling pathway downstream TLR4,p-NF-κB p65,DAG and PKC protein expression levels of observation group after treatment were significantly lower than those of control group（ P〈0. 05）; serum APN,Nesfatin-1 and ISI values of observation group after treatment were higher than those of control group while LP,Chemerin,RBP4 and FINS values were lower than those of control group（ P〈0.05）. Conclusions： Combined therapy of liraglutide and metformin can significantly improve the constitution of newly diagnosed type 2diabetic mellitus patients with obesity,optimize the general condition and be expected to improve treatment outcome.
出处
《海南医学院学报》
CAS
2016年第16期1792-1795,1799,共5页
Journal of Hainan Medical University
基金
陕西省科技计划项目(2010k15-03-02)~~
关键词
2型糖尿病伴肥胖
利拉鲁肽
二甲双胍
微炎症
Type 2 diabetic mellitus with obesity
Liraglutide
Metformin
Micro-inflammation
