利拉鲁肽治疗超重、肥胖2型糖尿病并肾脏疾病的临床观察

目的 观察利拉鲁肽治疗超重、肥胖2型糖尿病(type 2 dabetes mellitus,T2DM)并肾脏疾病的临床效果.方法 筛选超重、肥胖T2DM患者70例,糖化血红蛋白(glycated hemoglobin,HbA1c)符合(7％≤HbA1c≤11％),随机分成2组,胰岛素联合二甲双胍和(或)阿卡波糖组(胰岛...

Clinical observation of liraglutide in the treatment of overweight and obese type 2 diabetes mellitus with nephropathy

ObjectiveTo observe the clinical efficacy of liraglutide in the treatment of overweight, and obese type 2 dabetes mellitus(T2DM) complicated with nephropathy.MethodsSeventy overweight and obese T2DM patients with glycated hemoglobin(HbA1c)(7%≤HbA1c≤11%) were selected and randomly divided into two groups: insulin combined with metformin and/or acarbose group(insulin group) and liraglutide combined with metformin and/or acarbose group(liraglutide group). Before and at 24 weeks after treatment, body weight(WT), waist circumference(WC), HbA1c, insulin resistance index(HOMA-IR), urinary albumin creatinine ratio(UACR), estimation glomerular filtration rate(eGFR), serum and urinary α1 microglobulin(α1-MG), serum and urinary β2 microglobulin(β2-MG), and other indicators were analyzed.ResultsAt the end of the study, 30 patients in the insulin group completed the study and 31 patients in the liraglutide group completed the study. Compared with those before treatment, HbA1c, HOMA-IR, UACR, eGFR, serum α1-MG, urinary α1-MG, blood β2-MG and urinary β2-MG in the insulin group were lower significantly after treatment, which showed significant difference(P＜0.01). After treatment, WT, WC, body mass index, HbA1c, HOMA-IR, UACR, EGFR, serum α1-MG, urinary α1-MG, blood β2-MG, urinary β2-MG decreased significantly in liraglutide group compared with those before treatment, with statistical significance(P＜0.01). After treatment, UACR, eGFR, serum α1-MG, urinary α1-MG and urinary β2-MG decreased more significantly in the liraglutide group than in the insulin group, with statistical significance(P＜0.05).ConclusionIn the treatment of overweight and obese T2DM patients with nephropathy, liraglutide can not only reduce blood glucose and weight, but also improve renal function and delay the progression of nephropathy, and this effect is independent of the effect of lowering blood glucose.