实用医学杂志 ›› 2023, Vol. 39 ›› Issue (2): 170-174.doi: 10.3969/j.issn.1006⁃5725.2023.02.008

• 专题报道 • 上一篇    下一篇

聚乙二醇洛塞那肽联合二甲双胍治疗新诊断肥胖2型糖尿病

周英旎 石敏 赖敬波 李晓苗 刘向阳   

  1. 空军军医大学西京医院内分泌代谢科(西安 710032)

  • 出版日期:2023-01-25 发布日期:2023-01-25
  • 通讯作者: 刘向阳 E⁃mail:Liuxy5@163.com
  • 基金资助:

Efficacy of PEX168 combined with metformin in newly diagnosed obese patients with type 2 diabetes melli⁃ tus 

ZHOU Yingni,SHI Min,LAI Jingbo,LI Xiaomiao,LIU Xiangyang.    

  1. Department of Endocrinology and Me⁃ tabolism,Xijing Hospital,Air Force Medical University of PLA,Xi′an 710032,China

  • Online:2023-01-25 Published:2023-01-25
  • Contact: LIU Xiangyang E⁃mail:Liuxy5@163.com

摘要:

目的 探讨聚乙二醇洛塞那肽(PEX168)联合二甲双胍在新诊断肥胖 2 型糖尿病患者中 的安全性和有效性。方法 选取空军军医大学西京医院内分泌代谢科门诊共 80 例新诊断的肥胖 2 型糖 尿病患者,采用随机数字表法将其分为治疗组(n = 40)和对照组(n = 40),治疗组给予 PEX168 0.2 mg 每周 1 次,皮下注射联合二甲双胍 500 mg,每天 3 次口服治疗,对照组给予二甲双胍 500 mg 每天 3 次口 服单药治疗。12 周后,观察两组患者空腹血糖(FBG)、餐后 2 h 血糖(PBG)、糖化血红蛋白(HbA1c)、空 腹胰岛素(FINS)、体质指数(BMI)、血压(SBP/DBP)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆 固醇(HDL⁃C)、低密度脂蛋白胆固醇(LDL⁃C)、尿酸(UA),并对肾小球滤过率(eGFR)、胰岛素抵抗指数 HOMA⁃IR)和胰岛 β 细胞功能(HOMA⁃β)进行计算比较。同时观察两组患者各种不良反应的发生 情况。结果 12 周后,虽两组患者的 FBG、PBG、HbA1c、BMI、SBP、DBP、TG、TC、UA 均较前下降,但治疗 组下降幅度明显优于对照组,差异有统计学意义(P < 0.05),而对照组 LDL⁃C 较前无明显降低,治疗组 LDL⁃C 较前下降明显(P < 0.05),两组患者 HOMA⁃IR 均较治疗前改善(P < 0.05),治疗组下降幅度明显 优于对照组,差异有统计学意义(P < 0.05)。虽然 12 周后治疗组在 HOMA⁃β eGFR 改善方面与对照 组差异无统计学意义,但两组患者上述指标均较基线水平有所改善,且治疗组 eGFR 较前升高更明显。 结论 对于肥胖的新诊断 2 型糖尿病患者,PEX168 联合二甲双胍治疗能够快速有效的控制血糖、改善 胰岛细胞功能,同时可减轻体质量、降低血压、血脂、尿酸,具有明显的心血管及肾脏获益,并且不增加 不良事件的风险。

关键词:

聚乙二醇洛塞那肽, 二甲双胍, 2型糖尿病, 肥胖, 胰岛素抵抗

Abstract:

 Objective To investigate the safety and efficacy of polyethylene glycol loxenatide(PEX168 combined with metformin in newly diagnosed obese patients with type 2 diabetes mellitus(T2DM). Methods Eighty newly diagnosed obese patients with T2DM in the Department of Endocrinology and Metabolism of Xijing Hospital were selected and divided into treatment group(n = 40)and control group(n = 40)by random number table method. The treatment group was given PEX168 0.2 mg once a week combined with metformin 500 mg three times a day,and the control group with metformin 500 mg three times a day. After 12 weeks,fasting blood glucose (FBG),2⁃hour postprandial blood glucose(PBG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS), body mass index(BMI),blood pressure(SBP/DBP),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL⁃C),low density lipoprotein cholesterol(LDL⁃C)and uric acid(UA)were observed. The glomerular filtration rate(eGFR),insulin resistance index(HOMA⁃IR)and islet β⁃cell function(HOMA⁃β were calculated. Adverse reactions in the two groups were observed as well. Results After 12 weeks of treatment the lever of FBG,PBG,HbA1c,BMI,SBP,DBP,TG,TC,UA,HOMA⁃IR in both groups were lower,espe⁃ cially in the treatment group(P < 0.05). Significant decrease of LDL⁃C was observed in the treatment group,but not in the control group(P < 0.05). Although there was no significant difference in HOMA⁃β and eGFR between the two groups after 12 weeks of treatment,both of them were improved from baseline. Conclusion For newly diagnosed obese patientswith T2DM,PEX168 combined with metformin can rapidly and effectively control blood glucose,improve islet cell function,body weight,blood pressure,blood lipids and uric acid,and has significant cardiovascular and renal benefits,without increasing the risk of adverse events.

Key words:

polyethylene glycol losenatide, metformin, type 2 diabetes mellitus, obesity, insulin resistance