摘要
目的探讨艾塞那肽对超重/肥胖的2型糖尿病(type 2 diabetes mellitus,T2DM)患者的微量白蛋白尿(microalbuminuria,MAU)排泄及与内脏脂肪面积(visceral fat area,VFA)、体质指数(body mass index,BMI)、腰臀比(waist-to-hip ratio,WHR)的关系及影响。方法收集本科2015年1月至2016年6月就诊的符合标准的超重/肥胖的2型糖尿病患者76例,按简单随机化原则分成两组,在原口服降糖方案血糖控制不佳基础上,艾塞那肽组接受艾塞那肽注射液皮下注射,每日2次,对照组采用甘精胰岛素,每日1次,整个治疗共计24周。观察两组患者治疗前后MAU、VFA、BMI、WHR、空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(glycated hemoglobin,Hb A1c)的变化,并进行相关分析。结果艾塞那肽组患者在治疗12周和24周后的MAU、VFA、BMI、WHR、FBG、HbA1c较治疗前明显下降(P <0. 05),而对照组仅有BMI、FBG和Hb A1c呈现明显下降(P <0. 05)。艾塞那肽组VFA、BMI、WHR、MAU的变化与FBG、HbA1c的变化呈显著正相关(P <0. 05)。结论艾塞那肽可显著降低超重/肥胖的2型糖尿病患者的MAU排泄、血糖和体脂水平,且MAU排泄下降同VFA、BMI、WHR、血糖的降低密切相关。
Objective To investigate the relationship and effect of exenatide on microalbuminuria （MAU）, visceral fat area （VFA）, body mass index （BMI）, and waist-to-hip ratio （WHR） in overweight/obese patients with type 2 diabetes mellitus （T2DM）. Methods A total of 77 overweight/obese T2DM patients who met our criteria and admitted in our hospital from January 2015 to June 2016 were enrolled in this study. They were randomly divided into exenatide group and control group. Since their poor glycemic control by original oral hypoglycemic protocol, exenatide injection was given subcutaneously to the former group twice a day, and insulin glargine injection to the latter group, once a day for a total of 24 weeks. The changes of MAU, VFA, BMI, WHR, fasting plasma glucose （FPG） and glycated hemoglobin （HbA1c） were observed before and after treatment in the 2 groups, and the correlation analysis was made. Results The levels of MAU, VFA, BMI, WHR, PBG and HbA1c were significantly decreased in the exenatide group after 12 and 24 weeks’ treatment （P〈0.05）. In the exenatide group, the changes of MAU, VFA, BMI and WHR were positively correlated with those of PBG and HbA1c （P〈0.05）, while such differences were only found in the levels of BMI, PBG and HbA1c in the control group （P〈0.05）. In the exenatide group, the changes of MAU, VFA, BMI and WHR were positively correlated with those of PBG and HbA1c （P〈0.05）. Conclusion Exenatide obviously reduces MAU, obesity and blood glucose in overweight/obese T2DM patients, and the excretion of MAU is closely associated with the decreases of VFA,WHR, BMI and blood glucose.
作者
乔巧
徐静
王建
郑宏庭
童强
白倩
袁媛
QIAO Qiao;XU Jing;WANG Jian;ZHENG Hongting;TONG Qiang;BAI Qian;YUAN Yuan(Department of Endocrinology;Department of Nutriology,Second Affiliated Hospital,Army Medical University（Third Military Medical University）,Chongqing,400037,China)
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2018年第20期1883-1888,共6页
Journal of Third Military Medical University
基金
重庆市社会民生科技创新专项项目(CTSTC2015shmszx120014)
重庆市集成示范计划(CSTC2015jcsf10003)
第三军医大学第二附属医院临床科研项目(2014YLC20)~~
关键词
艾塞那肽
糖尿病
肥胖
微量白蛋白尿
内脏脂肪面积
exenatide
type 2 diabetes mellitus
obesity
microalbuminuria
visceral fat area
