德谷门冬双胰岛素联合利拉鲁肽强化治疗对超重/肥胖2型糖尿病患者的糖脂代谢及内脏脂肪指数的影响

doi:10.20047/j.issn1673-7210.2023.27.19

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摘要目的探讨德谷门冬双胰岛素联合利拉鲁肽（IDAL）强化治疗新诊断的超重/肥胖2型糖尿病患者对其糖脂代谢及内脏脂肪指数的影响。方法选择2021年5月至2022年6月在福建医科大学附属泉州第一医院内分泌科就诊的112例新诊断的超重/肥胖2型糖尿病患者为研究对象，根据随机数字表法将其分为IDAL组和餐时-基础胰岛素（BBI）组，各56例。强化治疗8周，比较两组治疗前后糖脂代谢指标、胰岛素抵抗相关指标、内脏脂肪指数及不良反应和用药依从性。结果治疗后，两组空腹血糖、餐后2 h血糖、糖化血红蛋白、果糖胺、甘油三酯、总胆固醇、低密度脂蛋白胆固醇较治疗前降低而高密度脂蛋白胆固醇较治疗前升高，且IDAL组甘油三酯、总胆固醇、低密度脂蛋白胆固醇低于BBI组，高密度脂蛋白胆固醇高于BBI组（P＜0.05）。治疗后，IDAL组体重指数、腰围、内脏脂肪指数较治疗前降低，且IDAL组低于BBI组（P＜0.05），两组稳态模型胰岛素抵抗指数较治疗前降低，且IDAL组低于BBI组（P＜0.05）。IDAL组胃肠道不良反应发生率高于BBI组，低血糖发生率低于BBI组，用药依从性高于BBI组（P＜0.05）。结论 IDAL强化治疗可有效改善超重/肥胖2型糖尿病患者的糖代谢指标，对脂代谢指标、胰岛素抵抗及内脏脂肪指数的改善更具优势且低血糖发生率更低，用药依从性更好。

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	黄文森1　　李靖云1　　洪真真2　　康锦芬1　　黄思婧1　　陈丽云1　　陈韵1

关键词 ：德谷门冬双胰岛素, 利拉鲁肽, 2型糖尿病, 糖脂代谢, 内脏脂肪指数

Abstract：Objective To investigate the effects of Insulin Degludec/Insulin Aspart and Liraglutide (IDAL) on glucose and lipid metabolism and visceral adiposity index in newly diagnosed overweight/obese patients with type 2 diabetes mellitus. Methods A total of 112 newly diagnosed overweight/obese type 2 diabetes mellitus patients who were treated in the Department of Endocrinology, Quanzhou First Hospital Affiliated to Fujian Medical University from May 2021 to June 2022 were divided into IDAL group and bolus-basal Insulin (BBI) group by random number table method, with 56 cases in each group. The two groups were intensive treated for eight weeks. The glucose and lipid metabolism indexes, insulin resistance related indexes, visceral adiposity index, the adverse reactions, and medication compliance were compared before and after treatment. Results After treatment, fasting blood glucose, 2 h postprandial blood glucose, glycated hemoglobin, fructosamine, triglyceride, total cholesterol, and low density lipoprotein cholesterol in both groups were lower than before treatment, while high density lipoprotein cholesterol was higher than before treatment, and triglyceride, total cholesterol and low density lipoprotein cholesterol in the IDAL group were lower than those in the BBI group, high density lipoprotein cholesterol was higher than that in BBI group (P＜0.05). After treatment, body mass index, waist circumference and visceral fat index in the IDAL group were lower than before treatment, and the IDAL group was lower than the BBI group (P＜0.05), and the steady-state model insulin resistance index in the two groups was lower than before treatment, and the IDAL group was lower than the BBI group (P＜0.05). The incidence of gastrointestinal adverse reaction in IDAL group was higher than that in BBI group, and the incidence of hypoglycemia in the IDAL group was lower than that in the BBI group, while the drug compliance was significantly higher (P＜0.05). Conclusion IDAL intensive therapy can effectively improve the glucose metabolism indexes of overweight/obese patients with type 2 diabetes, and has more advantages in the improvement of lipid metabolism indexes, insulin resistance and visceral adiposity index, and has a lower incidence of hypoglycemia and better medication compliance.

Key words： Insulin Degludec/insulin Aspart Liraglutide Type 2 diabetes mellitus Glucose and lipid metabolism Visceral adiposity index

基金资助:福建省自然科学基金科技项目（2018J01371）；
福建省泉州市科技计划项目（2018N109S）。

作者简介: 黄文森（1981-），男，硕士，副教授；研究方向：糖尿病等代谢性疾病。

引用本文:

黄文森1　　李靖云1　　洪真真2　　康锦芬1　　黄思婧1　　陈丽云1　　陈韵1. 德谷门冬双胰岛素联合利拉鲁肽强化治疗对超重/肥胖2型糖尿病患者的糖脂代谢及内脏脂肪指数的影响[J]. 中国医药导报, 2023, 20(27): 86-89,94.
HUANG Wensen1 LI Jingyun1 HONG Beverlysy2 KANG Jinfen1 HUANG Sijing1 CHEN Liyun1 CHEN Yun1. Effect of Insulin Degludec/Insulin Aspart combined with Liraglutide on glucose and lipid metabolism and visceral adiposity index in overweight/obese patients with type 2 diabetes mellitus. 中国医药导报, 2023, 20(27): 86-89,94.

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