艾塞那肽对新诊断2型糖尿病患者骨代谢的影响

 目的:观察24周胰高糖素样肽1受体激动剂艾塞那肽治疗对新诊断2型糖尿病患者骨密度及骨转化标志物的影响。方法:20名新诊断2型糖尿病患者，予以艾塞那肽治疗24周。治疗前后检测体重、空腹血糖（FPG）、餐后2 h血糖（PBG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、骨密度、体脂分布和空腹血清中的骨转化标志物水平，包括骨形成标志物骨钙素（OC）、骨吸收标志物Ⅰ型胶原交联羧基末端肽（CTX）和抗酒石酸酸性磷酸酶5b（TRAcP5b）。结果:新诊断2型糖尿病患者经过24周艾塞那肽治疗后，FPG、PBG和HbA1c降低（P<0.01），HOMA胰岛素抵抗指数改善(P<0.05)，体重及体脂含量下降（P<0.05）；虽然患者OC水平下降，骨吸收标志物（CTX和TRAcP5b）水平上升，骨密度增加，但均未达统计学意义。结论: 24周艾塞那肽治疗改善新诊断2型糖尿病患者的血糖和胰岛素抵抗，使体重及体脂含量下降，但尚未对患者骨密度及骨转化标志物产生影响。

Effect of exenatide on bone metabolism in patients with newly diagnosed T2DM

AIM:To assess the effect of glucagon-like peptide 1 (GLP-1) receptor agonist exenatide (EXE) on bone turnover markers and bone mineral density in newly diagnosed T2DM. METHODS:In this 24-week study, 20 newly diagnosed T2DM patients received EXE treatment. Hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), postprandial 2-hour blood glucose (PBG), fasting serum insulin (FINS), the bone turnover markers ［including osteoclasin (OC), C-telopeptide of type I collagen (CTX) and tartrate-resistant alkaline phosphatase 5b (TRAcP5b)］, bone mineral density and body fat distribution were assessed at baseline and week 24. RESULTS:At week 24, HbA1c, FPG and PBG declined (P<0.01), while homeostasis model assessment of insulin resistance was improved (P<0.05). EXE treatment also led to weight loss and decreased body fat mass (P<0.05). Regarding the measures of bone metabolism, therapy-induced changes in bone turnover markers and bone mineral density showed no significant changes. CONCLUSION: The therapy of 24-week EXE improved glycemic control and insulin resistance with weight loss and body fat mass reduction. No significant difference in bone turnover markers and bone mineral density was demonstrated after 24-week treatment.