利拉鲁肽联合胰岛素对 2 型糖尿病骨质疏松 患者血糖与骨代谢的影响

The Effect of Liraglutide Combined With Insulin in the Treatment of Type 2 Diabetic Osteoporosis on Blood Glucose and Bone Metabolism

摘要:

〔摘 要〕 目的：探究利拉鲁肽联合外源性胰岛素治疗 2 型糖尿病骨质疏松患者的疗效及对糖代谢、骨代谢的影响。 方法：选取 2018 年 4 月至 2020 年 6 月东莞市滨海湾中心医院收治的 90 例 2 型糖尿病骨质疏松患者作为研究对象，依照随 机数字表法将患者分为对照组（45 例）与观察组（45 例）。对照组予以阿仑膦酸钠、维生素 D3 及胰岛素注射治疗，观察 组在对照组的基础上加用利拉鲁肽皮下注射治疗。比较两组患者治疗前后的糖代谢指标、骨代谢指标。结果：两组患者治 疗后的空腹血糖（FBG）、糖化血红蛋白（HbA1c）及餐后 2 h 血糖（2h PG）水平均较治疗前明显下降，且观察组明显低 于对照组，差异具有统计学意义（P ＜ 0.05）；两组患者治疗后的 Ⅰ 型 β– 胶原片段（β–CTX）、骨钙素（BGP）、Ⅰ 型胶原 N 端前肽（PINP）、骨碱性磷酸酶（BALP）及血钙（Ca2+）水平均较治疗前有所改善，且观察组治疗后的 β–CTX、BGP 水平明显较对照组低，PINP、BALP、Ca2+ 水平较对照组高，差异具有统计学意义（P ＜ 0.05）。结论：采用利拉鲁肽与外 源性胰岛素联合治疗方案可明显降低 2 型糖尿病骨质疏松患者的血糖水平，并改善骨代谢情况。

Abstract:

〔Abstract〕 Objective To explore the curative effect of liraglutide combined with exogenous insulin in the treatment of type 2 diabetic osteoporosis and its effect on glucose and bone metabolism. Methods From April 2018 to June 2020, 90 patients with type 2 diabetic osteoporosis admitted to the Binhaiwan Central Hospital in Dongguan were selected as the research subjects. The patients were divided into control groups (45 cases) and observation group (45 cases). The control group was treated with alendronate sodium, vitamin D3 and insulin injections, and the observation group was treated with liraglutide subcutaneous injection on the basis of the control group. The glucose and bone metabolism indexes of the two groups of patients before and after treatment were compared. Results The fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c) and postprandial blood glucose (2h PG) levels of the two groups of patients after treatment were significantly lower than before treatment, but the decline in the observation group was significantly greater than that of the control group, and the difference was statistically significant Significance (P < 0.05); Type I β-collagen fragment (β-CTX), osteocalcin (BGP), type I collagen N-terminal propeptide (PINP), bone alkaline phosphatase (BALP) and blood calcium (Ca) levels were improved compared to before treatment, but the β-CTX and BGP levels of the observation group after treatment were significantly lower than those of the control group, and their PINP, BALP, and Ca2+ levels were higher than those of the control group. The differences were statistically significant (P < 0.05). Conclusion The combined treatment of liraglutide and exogenous insulin can significantly reduce the blood glucose level of patients with type 2 diabetic osteoporosis and improve bone metabolism.