摘要
目的探讨利拉鲁肽调控SIRT1/AMPK通路改善初诊超重/肥胖2型糖尿病患者糖脂代谢的疗效。方法前瞻性选取2019年1月至2021年1月河北中石油中心医院收治的初诊超重/肥胖2型糖尿病患者156例,按照随机数字表法将入组患者分为对照组和观察组,每组各78例。对照组患者接受二甲双胍治疗,观察组患者接受利拉鲁肽联合二甲双胍治疗,均持续24周。对比两组患者的糖代谢指标[空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)],脂质代谢指标[低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDLC)、总胆固醇(TC)、甘油三酯(TG)]及内脏脂肪面积、皮下脂肪面积、SIRT1/AMPK通路水平的差异。结果治疗24周后,观察组患者的FPG、Hb A1c、LDL-C、TC、TG、FINS、HOMA-IR水平及内脏脂肪面积、皮下脂肪面积为(6.11±0.79)mmol/L、(7.14±0.97)%、(2.93±0.46)mmol/L、(3.98±0.54)mmol/L、(1.92±0.31)mmol/L、(5.76±0.71)mIU/L、2.91±0.42、(104.38±12.92)cm^(2)、(187.32±22.07)cm^(2),低于对照组[(6.95±0.92)mmol/L、(7.96±1.23)%、(3.50±0.51)mmol/L、(4.75±0.61)mmol/L、(2.19±0.40)mmol/L、(6.53±0.79)m IU/L、3.47±0.49、(113.47±15.46)cm^(2)、(219.74±30.63)cm^(2)],HDL-C水平及外周血中SIRT1、AMPK的mRNA表达量为(1.27±0.26)mmol/L、0.89±0.12、0.75±0.11,均高于对照组[(1.19±0.21)mmol/L、0.80±0.11、0.67±0.09],差异均有统计学意义(P<0.05)。结论利拉鲁肽联合二甲双胍治疗可显著改善初诊超重/肥胖2型糖尿病患者的糖脂代谢水平并减轻胰岛素抵抗,可能与利拉鲁肽激活SIRT1/AMPK通路的作用相关。
Objective To investigate the efficacy of liraglupeptides regulating SIRT1/AMPK pathway in improving glucose and lipid metabolism in newly diagnosed overweight/obese type 2 diabetes mellitus patients.Methods A total of 156 newly diagnosed overweight/obese type 2 diabetes mellitus patients admitted to Hebei Petrochina Central Hospital from January 2019 to January 2021 were prospectively selected and divided into control group(n=78)and observation group(n=78)according to random number table method.Patients in control group were treated with metformin,those in observation group were treated with liraglutide combined with metformin for 24 weeks.The glucose metabolism indexes of the two groups of patients were fasting blood glucose(FPG),hemoglobin A1 C(HbA1 c),fasting insulin(FINS),insulin resistance index(HOMA-IR),lipid metabolism index low-density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),total cholesterol(TC),triacylglycerol(TG),visceral fat area,subcutaneous fat area,and SIRT1/AMPK pathway levels were compared.Results After 24 weeks of treatment,the levels of FPG,HbA1 c,LDL-C,TC,TG,FINS,HOMA-IR,visceral fat area and subcutaneous fat area of the observation group were(6.11±0.79)mmol/L,(7.14±0.97)%,(2.93±0.46)mmol/L,(3.98±0.54)mmol/L,(1.92±0.31)mmol/L,(5.76±0.71)mIU/L,2.91±0.42,(104.38±12.92)cm^(2),(187.32±22.07)cm^(2),which were lower than those of the control group[(6.95±0.92)mmol/L,(7.96±1.23)%,(3.50±0.51)mmol/L,(4.75±0.61)mmol/L,(2.19±0.40)mmol/L,(6.53±0.79)m IU/L,3.47±0.49,(113.47±15.46)cm^(2),(219.74±30.63)cm^(2)],the level of HDL-C and the expression of SIRT1 and AMPK mRNA in peripheral blood of the observation group were(1.27±0.26)mmol/L,0.89±0.12,0.75±0.11,which were higher than those of the control group[(1.19±0.21)mmol/L,0.80±0.11,0.67±0.09],the differences were statistically significant(P<0.05).Conclusion Liraglutide combines with metformin can significantly improve glucose and lipid metabolism,reduce insulin resistance in newly diagnosed overweight/obese type 2 diabetes mellitus patients,which may be related to the activation of SIRT1/AMPK pathway by liraglutide.
作者
韩洁
张伟
孙茜
石蕊
HAN Jie;ZHANG Wei;SUN Qian(Department of Endocrinology,Hebei Petrochina Central Hospital,Langfang Hebei 065000,China)
出处
《临床和实验医学杂志》
2021年第23期2527-2531,共5页
Journal of Clinical and Experimental Medicine
基金
2019年廊坊市科学技术局项目(编号:2019013121)。
