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利拉鲁肽对肥胖2型糖尿病患者胰高血糖素分泌的影响

[Effect of liraglutide on glucagon secretion in obese type 2 diabetic patients].

作者信息

Sun X F, Wang Y, Zhao W J, Wang L, Bao D Q, Qu G R, Yao M X, Luan J, Wang Y G, Yan S L

机构信息

Department of Endocrinology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China.

Department of Endocrinology, People's Hospital of Boxing County, Binzhou, Shandong province 256500, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2019 Jan 1;58(1):33-38. doi: 10.3760/cma.j.issn.0578-1426.2019.01.006.

Abstract

To investigate the effect of liraglutide on glucagon release in obese type 2 diabetes (T2DM). A multi-center, prospective, and self-comparison study was conducted in four hospitals in Qingdao. Twenty-four patients with T2DM were selected and treated with liraglutide for 12 weeks. Glucagon levels before and after treatment were detected before and 30 min, 60 min and 120 min after meals. After 12 weeks of treatment, the overall level of glucagon decreased, in which the differences in glucagon levels at 30 min [(220±79) ng/L vs. (203±77) ng/L, 0.05] and 60 min [(248±119) ng/L vs. (203±82)ng/L, 0.05] reached significance, respectively, comparing to those before treatment. The area under the curve of glucagon after treatment was significantly lower than that before treatment (438±190 vs. 389±153, 0.05). In contrast, after treatment, the overall level of C-peptide increased, especially the levels at 30 min [(1.53±1.02) nmol/L vs.(2.03±1.29) nmol/L], 60 min [(1.93±1.19) nmol/L vs. (2.48±1.75) nmol/L] and 120 min [(2.36±1.47) nmol/L vs. (2.96±1.84) nmol/L], all 0.05. The area under C-peptide curve increased significantly (3.6±2.2 vs. 4.6±2.9, 0.05). Fasting plasma glucose, postprandial 2 h plasma glucose and glycosylated hemoglobin A1c were all lower than before, and the differences were statistically significant (0.05). Waist circumference and body mass index were significantly lower than before (0.05). The amount of insulin used for the treatment decreased by approximately 55.1% compared with that before liraglutide, and the difference was statistically significant (0.05). Liraglutide inhibits glucagon secretion and lowers blood glucose. It can also reduce body weight, improve islet cell function and reduce insulin use in T2DM.

摘要

探讨利拉鲁肽对肥胖2型糖尿病(T2DM)患者胰高血糖素释放的影响。在青岛的四家医院进行了一项多中心、前瞻性、自身对照研究。选取24例T2DM患者,给予利拉鲁肽治疗12周。分别于治疗前及餐后30分钟、60分钟和120分钟检测治疗前后的胰高血糖素水平。治疗12周后,胰高血糖素总体水平下降,其中治疗后30分钟[(220±79)ng/L比(203±77)ng/L,P<0.05]和60分钟[(248±119)ng/L比(203±82)ng/L,P<0.05]时胰高血糖素水平与治疗前相比差异有统计学意义。治疗后胰高血糖素曲线下面积显著低于治疗前(438±190比389±153,P<0.05)。相反,治疗后C肽总体水平升高,尤其是餐后30分钟[(1.53±1.02)nmol/L比(2.03±1.29)nmol/L]、60分钟[(1.93±1.19)nmol/L比(2.48±1.75)nmol/L]和120分钟[(2.36±1.47)nmol/L比(2.96±1.84)nmol/L]时,差异均有统计学意义(P<0.05)。C肽曲线下面积显著增加(3.6±2.2比4.6±2.9,P<0.05)。空腹血糖、餐后2小时血糖及糖化血红蛋白A1c均低于治疗前,差异有统计学意义(P<0.05)。腰围和体重指数均显著低于治疗前(P<0.05)。与使用利拉鲁肽前相比,胰岛素用量减少约55.1%,差异有统计学意义(P<0.05)。利拉鲁肽可抑制胰高血糖素分泌并降低血糖。它还能减轻体重,改善胰岛细胞功能,并减少T2DM患者的胰岛素用量。

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