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中华老年病研究电子杂志 ›› 2022, Vol. 09 ›› Issue (01) : 16 -19. doi: 10.3877/cma.j.issn.2095-8757.2022.01.005

老年内分泌疾病

利拉鲁肽联合阿法骨化醇治疗老年2型糖尿病合并骨质疏松疗效分析
苟芳1, 张邱兵2,()   
  1. 1. 628000 四川省广元市中心医院内分泌科
    2. 628000 四川省广元市中心医院心血管内科
  • 收稿日期:2021-04-04 出版日期:2022-02-28
  • 通信作者: 张邱兵

Efficacy of liraglutide combined with alfacalccitol in the treatment of elderly patients with type 2 diabetes mellitus complicated with osteoporosis

Fang Gou1, Qiubing Zhang2,()   

  1. 1. Department of Endocrinology, Guangyuan Central Hospital, Guangyuan 628000, China
    2. Department of Cardiology, Guangyuan Central Hospital, Guangyuan 628000, China
  • Received:2021-04-04 Published:2022-02-28
  • Corresponding author: Qiubing Zhang
引用本文:

苟芳, 张邱兵. 利拉鲁肽联合阿法骨化醇治疗老年2型糖尿病合并骨质疏松疗效分析[J/OL]. 中华老年病研究电子杂志, 2022, 09(01): 16-19.

Fang Gou, Qiubing Zhang. Efficacy of liraglutide combined with alfacalccitol in the treatment of elderly patients with type 2 diabetes mellitus complicated with osteoporosis[J/OL]. Chinese Journal of Geriatrics Research(Electronic Edition), 2022, 09(01): 16-19.

目的

探讨利拉鲁肽联合阿法骨化醇治疗老年2型糖尿病合并骨质疏松患者的疗效。

方法

选择2018年6月至2020年3月四川省广元市中心医院收治的老年2型糖尿病合并骨质疏松患者67例。在常规降糖治疗、口服碳酸钙D3、饮食及运动干预的基础上,使用阿法骨化醇治疗33例(对照组),使用利拉鲁肽联合阿法骨化醇治疗34例(观察组)。比较两组的临床疗效、血糖控制情况、骨密度及骨代谢指标、不良反应发生情况。计量资料的比较采用t检验,计数资料的比较采用χ2检验。

结果

观察组治疗后临床有效率明显高于对照组(χ2=7.309,P<0.05)。治疗后,两组糖化血红蛋白、空腹血糖、餐后2 h血糖以及钙、碱性磷酸酶、骨密度、骨保护蛋白、艾帕素13、β胶原片段均明显改善(观察组:t=5.563、10.017、3.589、8.776、2.582、2.986、7.316、4.590、13.914,对照组:t=2.333、2.135、2.523、4.864、2.291、2.625、4.581、2.277、8.863,P<0.05),其中观察组改善情况较对照组更明显(t=5.076、6.757、2.942、4.905、2.204、2.455、2.625、2.576、6.014,P<0.05)。两组患者不良反应总发生率的差异无统计学意义(χ2=0.001,P>0.05)。

结论

利拉鲁肽联合阿法骨化醇治疗老年2型糖尿病合并骨质疏松患者的效果显著,能够提高患者的血糖控制水平,改善患者的骨密度及骨代谢指标。

Objective

To observe the efficacy of liraglutide combined with alfacalccitol in the treatment of elderly patients with type 2 diabetes mellitus (T2DM) complicated with osteoporosis.

Methods

A total of 67 elderly T2DM patients with osteoporosis admitted to Guangyuan Central Hospital from June 2018 to March 2020 were selected and randomly divided into control group (33 cases) and experimental group (34 cases). Both groups received conventional hypoglycemic treatment, oral calcium carbonate D3 therapy, diet and exercise intervention. Besides, the control group was treated with alfacalccitol, and the experimental group was treated with liraglutide combined with alfacalccitol. Clinical efficacy, blood glucose control, bone mineral density and bone metabolism indexes, and adverse reactions were compared between the two groups. T test was used to compare the measurement data, and χ2 test was used to compare the count data.

Results

The effective rate of experimental group was higher than that of control group (χ2=7.309, P < 0.05). Blood glucose control indicators like glycosylated hemoglobin, fasting blood glucose, 2-hour postprandial blood glucose, as well as bone mineral density and bone metabolism indicators like calcium, alkaline phosphatase, bone mineral density, osteoprotegerin, epoetin 13 and β collagen fragments, were all improved in both groups after treatment (observation group: t=5.563, 10.017, 3.589, 8.776, 2.582, 2.986, 7.316, 4.590, 13.914; control group: t=2.333, 2.135, 2.523, 4.864, 2.291, 2.625, 4.581, 2.277, 8.863; P < 0.05), and the experimental group showed significantly better improvement than the control group (t=5.076, 6.757, 2.942, 4.905, 2.204, 2.455, 2.625, 2.576, 6.014; P < 0.05). There was no significant difference in the total incidence of adverse reactions between two groups (χ2=0.001, P > 0.05).

Conclusion

Liraglutide combined with alfacalccitol has a significant effect on elderly patients with T2DM complicated with osteoporosis, which can improve blood glucose control, bone mineral density and bone metabolism, and is worthy of clinical application.

表1 两组血糖控制情况比较(±s
表2 两组骨密度及骨代谢指标比较(±s
[1]
卢艳慧,李春霖.老年2型糖尿病合并骨质疏松的临床进展[J].中华糖尿病杂志202012(6):353-356.
[2]
温滨红,张艳阳,赵璐,等.利拉鲁肽对糖尿病骨质疏松大鼠骨代谢、炎性反应和氧化应激的影响[J].中华骨质疏松和骨矿盐疾病杂志201710(6):550-556.
[3]
王盼,吴科锋,崔燎.不同阶段2型糖尿病诱发骨质疏松症的致病机制研究进展[J].中国骨质疏松杂志202026(4):619-624.
[4]
孟彩云,庄扬名. 2型糖尿病并发骨质疏松患者胰岛素样生长因子-1、骨碱性磷酸酶及1,25羟维生素D3表达水平及意义[J].临床军医杂志201947(6):628-629.
[5]
郑坤杰,耿建林,刘晴晴,等.胰岛素治疗初诊肥胖T2DM患者联用利拉鲁肽对微炎症及β细胞功能的影响[J].中国老年学杂志201939(20):4917-4920.
[6]
白婧,代嘉,高倩,等.利拉鲁肽治疗2型糖尿病合并骨质疏松患者血清趋化素水平和骨密度变化的研究[J].中国糖尿病杂志202028(3):207-210.
[7]
张志梅,张倩辉,李彩英,等.利拉鲁肽联合胰岛素治疗2型糖尿病骨质疏松的疗效[J].西北药学杂志201833(6):830-833.
[8]
王志刚,刘菊.利拉鲁肽对2型糖尿病骨质疏松大鼠miRNA-19a、miRNA-144及骨密度的影响[J].中国骨质疏松杂志202026(9):1297-1300.
[9]
孙晓方,王越,赵文娟,等.利拉鲁肽对肥胖2型糖尿病患者胰高血糖素分泌功能的影响[J].中华内科杂志201958(1):33-38.
[10]
Minami CA, Freedman RA. Menopausal hormone therapy and long-term breast cancer risk: further data from the women's health initiative trials[J]. JAMA, 2020, 324(4):347-349.
[11]
袁家楠,曹欢,杨慧慧,等.2型糖尿病合并骨质疏松患者血清sFRP5和Apelin-13水平与骨代谢标志物的关系[J].中华实用诊断与治疗杂志202034(10):1000-1003.
[12]
Chen K, Wu R, Mo B, et al. Comparison between liraglutide alone and liraglutide in combination with insulin on osteoporotic rats and their effect on bone mineral density[J]. J Musculoskel Neuron Interact, 2021, 21(1):142-148.
[13]
杨丽娜,杨靖,李娜,等. GLP-1受体激动剂利拉鲁肽对糖皮质激素性骨质疏松大鼠的疗效和作用机制研究[J].中国骨质疏松杂志201925(8):1100-1105.
[14]
Dymnova SE, Sergeeva VV. Clinical-functional features and problems of rehabilitation in patients with osteoporosis of the elderly age in combination with accompanying pathology[J]. Consilium Medicum, 2020, 22(12):84-88.
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