利拉鲁肽对超重、肥胖2型糖尿病患者内脏脂肪的影响

［摘要］目的观察利拉鲁肽对胰岛素联合二甲双胍治疗血糖控制不佳的超重、肥胖2型糖尿病（type 2 dabetes mellitus，T2DM）患者胰岛素抵抗及内脏脂肪的影响。方法筛选超重、肥胖T2DM患者80例，糖化血红蛋白（glycated hemoglobin,HbA1c）符合(7%≤HbA1c≤11％)，随机分成2组，胰岛素联合二甲双胍组（对照组）、胰岛素联合二甲双胍的基础上加用利拉鲁肽（利拉鲁肽组），治疗24周，观察治疗前后体重（body weight,WT）、腰围（waist circumference,WC）、体重指数（body mass index,BMI）、空腹血糖（fasting plasma glucose，FPG）、总胆固醇（total lesterol,TC）、三酰甘油（triglyceride,TG）、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇（high density lipoprotein cholesterol,HDL-C）、HbA1c、空腹胰岛素（fasting insulin,FINS）、胰岛素抵抗指数（insulin resistance index,HOMA-IR）及内脏脂肪面积（visceral fat area,VFA）的变化。结果治疗后，对照组FPG、TC、TG、LDL-C、HbA1c、FINS、HOMA-IR较治疗前均降低，HDL-C升高，差异有统计学意义（P＜0.05）；利拉鲁肽组WT、WC、BMI、 FPG、HbA1c、TC、TG、LDL-C、FINS、HOMA-IR、VFA较治疗前均降低，HDL-C升高，差异有统计学意义（P＜0.05）。治疗后，利拉鲁肽组WT、WC、BMI、VFA较对照组均降低（P＜0.05）。利拉鲁肽组与每日应用胰岛素剂量比对照组减少（P＜0.05）。VFA降低与WT、WC、BMI降低呈正相关（P＜0.05）。结论利拉鲁肽应用于超重、肥胖2型糖尿病患者不仅可以降低血糖还可以减轻体重，改善胰岛素抵抗，减少内脏脂肪，具有临床获益。

Effects of Liraglutide on visceral fat in overweight and obese patients with type 2 diabetes mellitus

［Abstract］ Objective〖HTSS〗To observe the effect of Lilalutide on insulin resistance and visceral fat in type 2 diabetes mellitus (T2DM) patients treated by insulin combined with metformin with poor glycemic control.〖WTHZ〗Methods〖HTSS〗Eighty cases of overweight and obese T2DM patients were screened, and the glycated hemoglobin(HbA1c) was consistent with that of 7%≤HbA1c≤ 11%. They were randomly divided into two groups, the insulin combined with metformin group(control group) and the insulin combined with metformin group with Liraglutide(Liraglutide group), and the treatment was conducted for 24 weeks. Body weight(WT) before and after treatment, waist circumference,(WC), body mass index(BMI), fasting blood sugar(FPG), total cholesterol(TC), three triglyceride(TG), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C), HbA1c, fasting insulin( FINS), insulin resistance index(HOMA-IR) and visceral fat area(VFA) changes were observed. 〖WTHZ〗Results〖HTSS〗After treatment, FPG, TC, TG, HbA1c, LDL -C,FINS, HOMA -IR in the control group were all reduced and HDL-C was increased, with statistically significant differences(P＜0.05). WT, WC, BMI, FPG, HbA1c, TC, TG, FINS, HOMA-IR and VFA were all reduced and HDL-C was increased in the Liraglutide group compared with that before treatment, the difference was statistically significant(P＜0.05).After treatment, WT, WC, BMI and VFA in Liraglutide group were all lower than those in the control group(P＜0.05). Compared with the control group, the daily insulin dose of Liraglutide group decreased(P＜0.05). Decreased VFA was positively correlated with decreased WT, WC and BMI(P＜0.05). 〖WTHZ〗Conclusion〖HTSS〗The application of Liraglutide in overweight and obese patients with type 2 diabetes can not only lower blood sugar but also reduce weight, improve insulin resistance and reduce visceral fat, with clinical benefits.