糖尿病与肥胖、脂质代谢

　　【摘要】 目的 比较利拉鲁肽与沙格列汀对肥胖T2DM患者的疗效及安全性。 方法 将75例BMI>28.0 kg/m2的T2DM住院患者分为利拉鲁肽组和沙格列汀组，联合二甲双胍治疗24周，检测治疗前后BMI、血压、FPG、2 hPG、HbA1c和血脂，记录低血糖发生情况和其他不良反应。 结果 利拉鲁肽、沙格列汀组治疗后BMI、SBP、DBP、FPG、2 hPG和HbA1c较治疗前降低[(25.32±2.68) vs (28.99±3.21)kg/m2，(27.20±4.07) vs (28.01±4.07)kg/m2;(122.42±13.32) vs (129.62±16.54)mmHg，(124.98±9.08) vs (128.98±15.87)mmHg;(83.00±7.60) vs (86.00±8.50)mmHg，(84.00±9.20) vs (87.00±6.50)mmHg;(6.64±1.47) vs (9.31±1.51)mmol/L，(6.61±1.82) vs (9.36±1.45)mmol/L;(8.20±5.40) vs (13.60±5.13)mmol/L，(7.98±3.42) vs (13.80±4.95)mmol/L;(6.85±0.98)% vs (9.07±0.86)%，(7.08±0.43)% vs (9.11±0.78)%，P<0.05]。利拉鲁肽组治疗后BMI、SBP和FPG较沙格列汀组低[(25.32±2.68) vs (27.20±4.07)kg/m2;(122.42±13.32) vs (124.98±9.08)mmHg;(6.64±1.47) vs (6.61±1.82)mmol/L，P<0.05]。两组均无严重低血糖事件发生，胃肠道不良反应发生率比较差异无统计学意义[9(25.7%) vs 9(24.3%)，P>0.05]。 结论 利拉鲁肽与沙格列汀均可改善肥胖T2DM患者血糖水平，且安全性较好，但利拉鲁肽更能降低患者体重、血压。

　　【关键词】利拉鲁肽;沙格列汀;肥胖;糖尿病，2型

　　【Abstract】 Objective To compare the efficacy and safety between liraglutide and saxagliptin in obese T2DM patients. Methods A total of 75 T2DM patients with BMI>28.0 kg/m2 were divided into two groups: 38 cases in liraglutide-treated group and 37 cases in saxagliptin-treated group. All the participants were also treated with metformin during follow up of 24 weeks.BMI, blood pressure, FPG, 2 hPG, HbA1c and blood lipids were measured before and after treatment，and the occurrence of hypoglycemia and other untoward effect were recorded. Results SBP, DBP, FPG, 2 hPG and HbA1c were significantly decreased in pre-vs post-treatment with liraglutide and saxagliptin respectively [SBP(122.42±13.32)vs(129.62±16.54)mmHg，(124.98±9.08)vs(128.98±15.87)mmHg];[DBP(83.00±7.60)vs(86.00±8.50)mmHg，(84.00±9.20)vs(87.00±6.50)mmHg];[FPG(6.64±1.47)vs(9.31±1.51)mmol/L，(6.61±1.82)vs(9.36±1.45)mmol/L];[2 hPG(8.20±5.40)vs(13.60±5.13)mmol/L，(7.98±3.42)vs(13.80±4.95)mmol/L];[HbA1c(6.85±0.98)% vs(9.07±0.86)%，(7.08±0.43)% vs(9.11±0.78)%]，(all P<0.05). BMI was significantly lower after treatment in liraglutide group[(25.32±2.68)vs(28.99±3.21)kg/m2]. BMI, SBP and FPG were significantly lower in liraglutide group than in saxagliptin group after treatment [BMI(25.32±2.68) vs(27.20±4.07)kg/m2;SBP(122.42±13.32)vs(124.98±9.08)mmHg;FPG(6.64±1.47) vs(6.61±1.82)mmol/L，P<0.05]. No significant difference inadverse events were found between two groups and no severe hypoglycemia was occurred in two groups. Conclusion Both liraglutide and saxagliptin could effectively and safely control blood glucose in obese T2DM. Liraglutide may be more effective in weight and blood pressure reduction than saxagliptin.

　　【Key words】Liraglutide;Saxagliptin;Obesity;Diabetes mellitus, type 2