摘要
目的:观察利拉鲁肽对腹型肥胖2型糖尿病(T2DM)患者肠道菌群及脂肪细胞因子水平的影响。方法:128例腹型肥胖T2DM患者随机分为两组。两组均给予常规降糖方案治疗,在此基础上,对照组加用小剂量利拉鲁肽(初始剂量0.6 mg qd,1周后剂量增加至1.2 mg qd),观察组加用大剂量利拉鲁肽(初始剂量0.6 mg qd,2周后剂量增加至1.8 mg qd)。治疗3个月后,比较两组血糖水平[空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、平均血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)]、临床指标[胰岛素分泌指数(HOMA⁃β)、胰岛素抵抗指数(HOMA⁃IR)、空腹C肽、腹内脂肪含量、腰围]、肠道菌群(肠杆菌、酵母菌、双歧杆菌、乳杆菌)、脂肪细胞因子[脂联素、瘦素、爱帕琳肽(Apelin)⁃13]、Th17/Treg水平等指标变化,以及药品不良反应发生情况。结果:治疗后,两组患者的FPG、2 hPG、HbA1c、MAGE、MODD、HOMA⁃IR、腹内脂肪含量、腰围、肠杆菌、酵母菌、瘦素、Th17、Th17/Treg水平等均较前明显降低,HOMA⁃β、空腹C肽、双歧杆菌、乳杆菌血清脂联素、Apelin⁃13、Treg水平等则较前升高(P<0.05);且观察组上述指标均优于对照组(P<0.05)。两组药品不良反应发生率差异无统计学意义(P>0.05)。结论:大剂量利拉鲁肽有助于调节腹型肥胖T2DM患者脂肪细胞因子水平,改善胰岛素抵抗,纠正肠道菌群失调,控制血糖,且安全性高。
Objective:To investigate the effects of liraglutide on intestinal flora and adipocytokine levels in type 2 diabetes mellitus(T2DM)patients with abdominal obesity.Methods:One hundred and twenty⁃eight T2DM patients with abdominal obesity in our hospital were selected and divided into two groups by the random number table method.Both groups were given the conventional glucose⁃lowering regimens,and additionally,the control group was given a small dose of liraglutide at an initial dose of 0.6 mg qd,and the dose was increased to 1.2 mg qd after one week of treatment;the obser⁃vation group was given a high dose of liraglutide at an initial dose of 0.6 mg qd,and the dose was increased to 1.8 mg qd af⁃ter 2 weeks of treatment.After 3 months of treatment,the blood glucose levels[fasting blood glucose(FPG),2 h post⁃prandial blood glucose(2 hPG),glycated hemoglobin(HbA1c),mean amplitude of blood glucose fluctuations(MAGE),mean absolute difference between day⁃to⁃day blood glucose(MODD)],clinical indicators[insulin secretion index(HO⁃MA⁃β),insulin resistance index(HOMA⁃IR)fasting C⁃peptide,intra⁃abdominal fat content,waistline],intestinal flora(enterobacter,yeast,bifidobacteria,lactobacillus),adipocytokines(adiponectin,leptin,epalenin Apelin⁃13),adipocy⁃tokines changes in Th17/Treg levels,and occurrence of adverse drug reactions were compared between the two groups.Re⁃sults:After treatment,FPG,2 hPG,HbA1c,MAGE,MODD,HOMA⁃IR,leptin,Th17,Th17/Treg levels,intra⁃ab⁃dominal fat content,waistline,enterobacteriaceae and yeast were lower than those before treatment,and HOMA⁃β,fasting C⁃peptide levels,serum lipocalin,Apelin⁃13,Treg levels,bifidobacterium and lactobacillus were higher than those before treatment in both groups.All the indicators in the observation group were better than those in the control group(P<0.05).The difference in the incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Con⁃clusion:High⁃dose liraglutide helps regulate adipo
作者
李敏
高瑞超
张志佳
刘旋
童玉环
檀增桓
Li Min;Gao Ruichao;Zhang Zhijia;Liu Xuan;Tong Yuhuan;Tan Zenghuan(Second Endocrine Department of Handan Central Hospital,Hebei Handan 056000,China)
出处
《药物流行病学杂志》
CAS
2022年第12期794-798,共5页
Chinese Journal of Pharmacoepidemiology
基金
河北省卫生和计划生育委员会科研基金项目(编号:20200472)。
关键词
2型糖尿病
腹型肥胖
利拉鲁肽
血糖
胰岛素抵抗
肠道菌群
脂肪细胞因子
Type 2 diabetes
Abdominal obesity
Liraglutide
Blood glucose
Insulin resistance
Intestinal flo⁃ra
Adipocytokines
