艾塞那肽及门冬胰岛素30注射液对不同基线特征糖尿病患者血管功能状态的影响

目的:比较艾塞那肽和门冬胰岛素30注射液对不同基线特征2型糖尿病（T2DM）患者颈动脉内膜中层厚度（cIMT）的影响，探讨艾塞那肽改善动脉粥样硬化（AS）的影响因素。方法:选取2015年3月10日至2017年6月20日于北京医院内分泌科门诊就诊的T2DM患者为研究对象，共纳入资料齐全符合入选条件的患者59例。研究设计为...

Effects of exenatide and insulin aspart 30 on vascular function in diabetic patients with different baseline characteristics

Objective To compare the effects of exenatide and insulin aspart 30 injection on carotid intima-media thickness(cIMT)in patients with type 2 diabetes mellitus(T2DM)with different baseline characteristics,and to explore the influencing factors of exenatide in improving atherosclerosis(AS).Methods A total of 59 patients with T2DM who were admitted to the Department of Endocrinology of Beijing Hospital from March 10,2015 to June 20,2017 were enrolled.The study was designed as a randomized,prospective,parallel positive drug control study.According to the baseline cIMT<1 mm and≥1 mm,the patients were divided into the following groups:baseline non-atherosclerotic group and baseline atherosclerotic group;according to body mass index(BMI)<24 kg/m² and≥24 kg/m²,they were divided into normal weight group,overweight and obesity group;according to the baseline glycosylated hemoglobin A1c(HbA_1c)<8.5%and HbA_1c≥8.5%,they were divided into general hyperglycemia group and significant hyperglycemia group;according to the decrease of HbA_1c<1.5%and HbA_1c≥1.5%at 52th week,the patients were assigned to the general hypoglycemic effect group and the good hypoglycemic effect group.The cIMT was measured.The results of each group were compared by group t test,nonparametric test andχ² test.Results The prevalence rate of carotid atherosclerosis in patients with T2DM was 64.41%(38/59).After 52 weeks of treatment with exenatide,the cIMT of patients with baseline AS was significantly lower than that of patients without baseline AS(P=0.02).After 52 weeks of treatment with exenatide,the cIMT decreased in overweight and obese subjects,but slightly increased in normal weight subjects,and the difference was not statistically significant(P=0.21).After 52 weeks of treatment,the cIMT decreased in both the general hypoglycemic effect group and the good hypoglycemic effect group,but the difference was not statistically significant(P=0.17).After treatment with exenatide,there was no correlation between cIMT changes and blood glucose,low density lipoprotein cholesterol and BMI changes within 52 weeks(P=0.576,0.188 and 0.352,respectively).Conclusions In patients with atherosclerosis at baseline,the improvement of cIMT was more significant and the benefit was greater after the administration of exenatide.cIMT levels were not affected by baseline body weight and hypoglycemic efficacy,and had no correlation with BMI and blood glucose changes after exenatide treatment.