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度拉糖肽对2型糖尿病合并骨质疏松患者糖代谢、骨代谢的影响

Effect of dulaglutide on glucose metabolism and bone metabolism in patients with type 2 diabetes mellitus complicated with osteoporosis

    摘要
  • 摘要:
    目的 探讨度拉糖肽联合胰岛素对2型糖尿病合并骨质疏松患者糖代谢、骨代谢的影响。
    方法 选择2019年5月至2020年2月诊治的2型糖尿病合并骨质疏松患者80例，按照治疗方式的不同分为观察组(n=36)和对照组(n=44)，对照组给予口服阿仑膦酸钠、口服维生素D3、皮下注射门冬胰岛素30等治疗，观察组在对照组的基础上给予度拉糖肽皮下注射，0.75 mg，每周1次。治疗3个月后，比较两组患者治疗前后的体质量指数(BMI)、糖代谢指标(FPG、2hPG、HbA1c)、骨质疏松相关因子(BMD、OC、P1NP、β-CTX)及骨代谢指标(ALP、BAP、OPG)，并统计两组患者的不良反应发生率。
    结果 治疗后两组患者的FPG、2hPG、HbA1c均显著低于治疗前(P < 0.05)，且观察组的各指标显著低于对照组(P < 0.05)。治疗后两组患者的骨质疏松相关因子均得到了改善，且观察组的BMD、骨钙素水平高于对照组，观察组β-CTX、P1NP均低于对照组(均P < 0.05)；治疗后两组患者的骨代谢指标均显著改善，且观察组的各项指标均高于对照组(P < 0.05)。两组患者的不良反应发生率无统计学差异。
    结论 度拉糖肽联合胰岛素治疗可有效控制2型糖尿病骨质疏松患者的血糖，并改善患者的骨代谢情况，增加患者的骨密度，可在临床上进一步推广。

     

    Abstract:
    Objective To explore the effect of dulaglutide on glucose metabolism and bone metabolism in patients with type 2 diabetes mellitus complicated with osteoporosis.
    Methods From May 2019 to February 2020, 80 patients with type 2 diabetes mellitus complicated with osteoporosis were treated and selected. According to different treatment methods, they were divided into two groups: the observation group (n=36) and the control group (n=44). The control group was treated with oral alendronate, vitamin D3, subcutaneous injection of aspartic insulin 30 and so on. The observation group was treated with subcutaneous injection of 0.75 mg dulaglutide on the basis of the control group, once a week. After 3 months of treatment, the body mass index (BMI), glucose metabolism index (FPG, 2hPG, HbA1c), osteoporosis related factors (bone mineral density, osteocalcin, P1NP, β-CTX), and bone metabolism index (ALP, BAP, OPG) of the two groups were compared before and after treatment, and the adverse reactions rates were calculated.
    Results After treatment, FPG, 2hPG, and HbA1c in the two groups were significantly lower than before treatment (P < 0.05), and the indexes in the observation group were significantly lower than those in the control group (P < 0.05). The BMD and osteocalcin levels in the two groups were increased, and the levels in the observation group were significantly higher than those in the control group (P < 0.05). The PINP and β-CTX levels in the two groups were significantly decreased (P < 0.05), and the P1NP and β-CTX levels in the observation group were significantly lower those in the control group (P < 0.05).
    Conclusions Dulaglutide combined with insulin can effectively control blood glucose, improve bone metabolism, and increase bone density in patients with type 2 diabetes mellitus complicated with osteoporosis.

     

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