·糖尿病临床研究·　

　　【摘要】 目的 研究在二甲双胍、阿卡波糖及噻唑烷二酮最大有效剂量治疗未能获得血糖控制的肥胖T2DM患者应用人胰升血糖素样肽-1 (GLP-1)受体激动剂艾塞那肽改善血糖的能力、对胰岛素敏感性及体重的影响。方法 30名患者随机分两组，为期30周。实验组使用艾塞那肽，对照组采用胰岛素强化治疗，于第12周及30周观察FPG)、2 hPG、HbA1c、FC-P【1】水平。结果 两组血糖、HbA1c下降差异无统计学意义(P>0.05)。BMI实验组下降，对照组增加(P<0.05)。两组HOMA-IR均下降，但实验组较对照组下降明显(P<0.05)。实验组无低血糖事件发生。结论 艾塞那肽能有效控制血糖以外的收益，即明显减轻体重，并增加胰岛素敏感性。

　　【关键词】 糖尿病，2型;肥胖;胰升血糖素样肽-1;艾塞那肽;

Effect of Exendin 4 on obesity T2DM XU Jing, SONG Xao-yan, FU Yu. Department of Endocrinology, Shenyang NO.5 People's Hospital, Shenyang 110023, China.

Corresponding author: SONG Xiao-yan, Email: SYX660120@126.com

　　【Abstract】Objective To observe the blood glucose controlling effect of glucagon-like peptide-1 receptor agonist Exendin-4 on obesity T2DM patients whose blood glucose can not be controlled well by maximum dose of metformin, acarbose and thiazolidine and the effect of Exendin-4 on insulin sensitivity and body weight. Methods Thirty patients were randomized into 2 groups and the study lasted for 30 weeks. Exendin-4 was used in the experimental group and insulin in the control group. The changes in the levels of fasting blood glucose (FPG), two-hour postprandial blood glucose (2 hPG), hemoglobin A1c (HbA1c) and fasting C-peptide (FC-P) were observed at the 12th and 30th weeks. Results The blood glucose and HbA1c of the two groups decreased at the 30th week (p>0.05). BMI in the experimental group decreased and in the control group increased (p<0.05). The HOMA-IR (CP) of the two groups decreased and the decrease in the experimental group was more than that in the control group (p<0.05). No hypoglycemia happened in the experimental group. Conclusion Exendin-4 can reduce blood glucose and body weight efficiently. And it can improve the sensitivity of insulin at the same time.

　　【Key words】Diabetes mellitus, type 2; Obesity; Glucagon-lik peptide-1; Exendin-4