艾塞那肽对血糖控制不佳的肥胖糖尿病患者疗效分析
| 作者: |
1蒋艳敏,
1徐湘,
1卜瑞芳,
1朱圣炜,
1陈诚
1 南京医科大学附属无锡人民医院内分泌科，江苏 无锡 214023 |
| 通讯: |
卜瑞芳
Email: purf@wuxiph.com |
| DOI: | 10.3978/j.issn.2095-6959.2016.05.009 |
摘要
目的：观察血糖控制不佳的肥胖2型糖尿病(type 2 diabetes mellitus，T2DM)患者加用艾塞那肽后的疗效。方法：选取研究对象60例(退出3例，实际完成57例)，根据不同体重指数(BMI)分为A组(25 kg/m2≤BMI<30 kg/m2)23例，B组(30 kg/m2≤BMI<35 kg/m2)27例，C组(35 kg/m2≤BMI<40 kg/m2)7例，连续给予艾塞那肽治疗12周，比较治疗前后3组患者的临床疗效及血清指标变化。结果：随访结束后，所有患者平均空腹血糖(fasting blood glucose，FBG)水平、HbA1c、体重和BMI、血脂(TC、TG、LDL)等较基线有明显下降(P<0.05)；所有患者平均空腹胰岛素(fasting serum insulin，FINS)水平较治疗前有所升高(P>0.05)，所有患者HOMA-IR较治疗前明显降低(P均<0.05)，HOMA-β较治疗前无显著变化(P>0.05)。3组间比较显示，各组FBG下降幅度C组>B组>A组(P>0.05)；HbA1c下降幅度水平C组>A组(P<0.05)；体重减轻幅度和BMI的下降幅度依次为C组>B组>A组(P均<0.05)。结论：艾塞那肽可以有效控制血糖控制不佳的肥胖T2DM患者的FBG、HbA1c，改善血脂水平和胰岛功能，减轻体重和BMI。其中，艾塞那肽对FBG、HbA1c、体重、BMI的疗效，在BMI较高组中疗效更显著。
关键词：
艾塞那肽
体重指数
肥胖
2型糖尿病
Study on the efficacy of exenatide on type 2 diabetes patients with obese and poor glycemic control
CorrespondingAuthor: BU Ruifang Email: purf@wuxiph.com
DOI: 10.3978/j.issn.2095-6959.2016.05.009
Abstract
Objective: To study the efficacy of exenatide on poor blood glucose control of the type 2 diabetes patients with obese. Methods: Sixty type 2 diabetes cases (57 cases completed) were selected and divided into three groups based on BMI: group A (25 kg/m2 ≤ BMI <30 kg/m2) (n=23), group B (30 kg/m2≤ BMI <35 kg/m2) (n=27), group C (35 kg/m2 ≤ BMI <40 kg/m2) (n=7). All the cases were treated with exenatide for 12 weeks, then compared the clinical efficacy and the change of serum indexes of the three groups before and after treatment. Results: By the end of follow-up, the average level of FBG, HbA1c, BMI, body weight and blood lipid (TC, TG, LDL) of all patients decreased significantly compared to the baseline (P<0.05). The average level of FINS increased (P>0.05). The HOMA-IR of patients was significantly lower than those before treatment (P<0.05), no significant difference shown in HOMA-IR. Comparison among the three groups showed that the range of FBG decreased was group C > group B > group A (P>0.05), the range of HbA1c decreased was group C > group A (P<0.05), the range of BMI decreased and weight loss was group C > group B > group A (P<0.05). Conclusion: Exenatide can effectively control the FBG, HbA1c, BMI, and body weight. It also can improve the blood lipid level and islet function.