胰高血糖素样肽-1类似物对2型糖尿病患者血脂的影响

摘要

目的探讨胰高血糖素样肽-1( GLP-1)对2型糖尿病患者血脂变化的影响。方法选择2013年1月至2014年6月间我院收治的2型糖尿病患者108例，根据随机数字表将所有患者分成对照组(口服二甲双胍)和观察组(注射百泌达)，连续应用12周，观察两组患者血糖、血脂变化情况及影响血脂变化的指标。结果　　治疗后，两组空腹血糖、餐后2 h 血糖、糖化血红蛋白水平和 BMI 与治疗前比较，差异有统计学意义( P <0．05)，观察组与对照组比较，差异有统计学意义(P<0．05)。治疗后，两组三酰甘油、总胆固醇、低密度脂蛋白和高密度脂蛋白水平与治疗前比较，差异有统计学意义(P<0．05)，观察组与对照组比较，差异有统计学意义(P<0．05)。患者BMI、血糖、糖化血红蛋白、血清胰岛素和胰岛素抗体水平均为影响GLP-1类似物致2型糖尿病患者血脂变化的因素。结论 GLP-1类似物可改善2型糖尿病患者的血脂情况，降低三酰甘油、总胆固醇、低密度脂蛋白含量，提高高密度脂蛋白含量，但在临床中仍需要结合患者自身因素进行临床治疗，以取得理想疗效。%Objective To explore the clinical effects of glucagon-like peptide-1 on plasma lipid metabolism of type 2 diabetes. Methods 108 patients with type 2 diabetics were chose in our hospital from January 2013 to June 2014. They were divided into 2 groups randomly,observation group was treated with GLP-1 and control group was trea-ted with oral metformin for 12 weeks. The blood sugar related indexes in lipid metabolism and the factors affecting lipid metabolism of the two groups were observed. Results After treatment, there were significant differences in FPG, 2hPG,HbA1c and BMI of the two groups compared with those before treatment (P<0. 05),and the indexes in obser-vation group were significant lower than those of control group ( P<0. 05). After treatment, there were significant differences in triglycerides,total cholesterol,LDL and HDL of the two groups compared with those before treatment (P<0. 05),and there were significant differences between the two groups (P <0. 05). The BMI,blood glucose, HbA1c,insulin and insulin antibody levels were the influence factors in the changes of plasma lipid metabolism of type 2 diabetes induced by glucagon-like peptide-1. Conclusion GLP-1 can improve lipid metabolism of type 2 diabetes,it could decrease the triglycerides,total cholesterol and LDL,and increase HDL. Treatment should consider the individual factors to get satisfying results.