摘要
目的对比观察由二甲双胍、噻唑烷二酮类(TZDs)、胰升糖素样肽1(GLP-1)类似物构成的三联降糖方案与传统降糖方案对2型糖尿病合并代谢综合征患者的疗效及安全性。方法针对82例2型糖尿病合并代谢综合征患者进行随机化、开放性、平行对照的26周前瞻性干预研究,比较三联疗法与传统疗法(各41例)在降糖、体重、腰围、内脏脂肪面积各方面的控制程度。结果治疗26周时,三联组HbA1C的降幅大于传统组[(2.23±1.75)%对(1.48±1.59)%,P<0.05];三联组体重指数、腰围、内脏脂肪面积的降幅均大于传统组[分别为(2.50±1.81对0.92±1.82)kg/m^2,(6.75±4.92对1.66±3.25)cm,(24.10±19.10对10.02±20.10)cm^2,均P<0.01]。三联组HbA1C和空腹血糖的达标率高于传统组(均P<0.05)。三联组无低血糖发生。三联组胃肠道反应发生率虽显著高于传统组(18.87%对3.92%,P<0.05),但其中90%为轻度胃肠道反应。结论由二甲双胍、TZDs和GLP-1类似物构成的三联降糖方案与传统降糖方案相比,除了能有效降糖外,还能更有效降低体重、缩小腰围、减少内脏脂肪,是一项适合2型糖尿病合并代谢综合征患者的优化治疗方案。
Objective The aim of this study was to compare the efficacy and safety of metformin/thiazolidinediones (TZDs) / glucagon-like peptide 1 (GLP-1) analogs (triple therapy) with conventional glucose-lowering therapy(conventional therapy) for patients with type 2 diabetes and metabolic syndrome.Methods A prospective randomized-controlled 26-week study was carried out. A total of 82 patients with type 2 diabetes and metabolic syndrome were randomized to receive either triple therapy protocal or just conventional therapy, altogether with 41 cases in each group.Results HbA1C value was significantly reduced in triple therapy group versus the conventional therapy group [(2.23±1.75)% vs (1.48±1.59)%, P<0.05]. Values of body mass index, waist circumference, and visceral fat area were significantly reduced in triple therapy group as compared to those of conventional therapy group [(2.50±1.81 vs 0.92±1.82)kg/m^2, (6.75±4.92 vs 1.66±3.25)cm, (24.10±19.10 vs 10.02±20.10)cm^2, all P<0.01, respectively]. Control rates of HbA1C and fasting plasma glucose for triple therapy were higher than those for conventional therapy (both P<0.05). No hypoglycemia occurred in triple therapy group. Subjects receiving triple therapy experienced more frequent gastrointestinal side effects than those in conventional therapy group (18.87% vs 3.92%, P<0.05). The most common side event was mild nausea (90%).Conclusion Combination therapy with metformin/TZDs/GLP-1 analogs had statistically significant advantages in the control of body weight, waist circumference, and visceral fat area in addition to the control of blood glucose over conventional glucose-lowering therapy in our patient cohort, it seems to be an optimized therapeutic regimen for patients with type 2 diabete and metabolic syndrome.
作者
康庄
罗志丹
张虹
郭瑞金
苏恒
薛元明
马丽晶
能琼俐
Kang Zhuang;Luo Zhidan;Zhang Hong;Guo Ruijin;Su Heng;Xue Yuanming;Ma Lijing;Neng Qiongli(Department of Endocrinology,the First Peopled Hospital of Yunnan Province,Kunming 650011,China;Department of Geriatric,Chongqing People’s Hospital,Chongqing 400014,China)
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2019年第9期736-742,共7页
Chinese Journal of Endocrinology and Metabolism
关键词
糖尿病
2型
代谢综合征
三联降糖方案
Diabetes mellitus,type 2
Metabolic syndrome
Triple glucose-lowering therapy
