艾塞那肽改善2型糖尿病患者血脂谱及血脂达标率的临床研究

摘要

目的：艾塞那肽是胰高糖素样肽-1受体激动剂,在降糖作用的同时,对血脂等代谢指标也具有潜在的疗效。本试验观察艾塞那肽对初发2型糖尿病患者血糖、体重及血脂谱的治疗效果及血脂的达标率改善情况。方法：对48例初发糖尿病,且体重指数≥24 kg/m2的患者，给予艾塞那肽治疗12周，观察对患者血糖、非高密度脂蛋白胆固醇（non-HDLC）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白B、胰岛素抵抗指数（HOMA-IR）及胰岛β细胞功能（HOMA-B）的治疗效果。结果：艾塞那肽治疗12周后，患者血浆糖化血红蛋白水平与基线相比显著降低[（9.81±2.13） vs（6.44±0.83），P<0.01]。此外,与治疗前相比, non-HDLC水平[（4.13±1.31） vs（3.44±0.98），P<0.01]显著下降,低密度脂蛋白胆固醇水平[（3.13±0.92） vs（2.84±0.87），P<0.05]显著下降，载脂蛋白B水平[（0.92±0.26 vs（0.86±0.29），P<0.05]显著下降。经艾塞那肽治疗，患者的LDL-C, non-HDLC及TG达标率均有提高，其中non-HDLC（29.2% vs 54.2%，P<0.05）及甘油三酯（33.3% vs 58.3%，P<0.05）在治疗前后达标率存在显著差异。结论：艾塞那肽治疗2型糖尿病除有效控制血糖外,对患者血脂水平也可以发挥一定的调节作用，具有潜在的降低2型糖尿病患者的心血管事件风险。%Objective: Exenatide is an anti-diabetes drug of glucagon-like peptide-1 receptor agonist. Besides of the anti-diabetes effect, exenatide also has potential therapeutic effects on lipid metabolism. The purpose of present research was to investigate the effects of exenatide on the metabolism of glucose and lipid in newly diagnosed type 2 diabetes patients.Methods:A total of 48 newly diagnosed over weight T2DM patients were recruited from the endocrinology departments of Beijing Chao-yang Hospital. The changes in plasma metabolic parameters of glucose and lipid were measured before and after exenatide treatment. Results:After the 12 weeks treatment of exenatide, HbA1C level was significantly lower than baseline [ (9.81±2.13) vs (6.44±0.83), P< 0.01]. Non-high density lipoprotein cholesterol (non-HDLC) level was significantly lower than that before treatment[ (4.13±1.31) vs (3.44±0.98),P<0.01]. Low density lipoprotein cholesterol (LDL-C) [ (3.13±0.92) vs (2.84±0.87),P<0.05] and Apo B [ (0.92±0.26) vs (0.86±0.29),P<0.05] were significantly lower than that before treatment. After the treatment, the attainment rate of LDL-C, non-HDLC and triglyceride (TG) were elevated. The difference of non-HDLC (29.2% vs 54.2%,P<0.05) and TG (33.3% vs 58.3%, P<0.05) were significant before and after treatment.Conclusion: Exenatide could be used to control plasma glucose and decrease body weight effectively, and to improve lipid metabolism of type 2 diabetic patients at the same time. The effects may protect patients from cardio-vascular events.