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吡格列酮二甲双胍与西他列汀对未经治疗的2型糖尿病患者骨密度和身体成分的影响。

Effect of Chiglitazar and Sitagliptin on Bone Mineral Density and Body Composition in Untreated Patients with Type 2 Diabetes.

作者信息

Wang Yuming, Zhou Yunting, Zhou Xiao, Su Xiaofei, Xu Xiaohua, Li Huiqin, Ma Jianhua

机构信息

Department of Geriatrics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, People's Republic of China.

Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210012, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2023 Dec 27;16:4205-4214. doi: 10.2147/DMSO.S439479. eCollection 2023.

Abstract

AIM

To evaluate the changes in bone mineral density (BMD) and body composition in untreated patients with type 2 diabetes mellitus (T2DM) before and after chiglitazar or sitagliptin treatment.

METHODS

A total of 81 patients with T2DM were randomly divided to receive chiglitazar or sitagliptin treatment for 24 weeks (54 in the chiglitazar group and 27 in the sitagliptin group). We measured the spine lumbar BMD, hip BMD, fat mass (FM), fat-free mass (FFM), percent body fat (%BF), android FM, gynoid FM and skeleton muscle mass (SMM) using dual-energy X-ray absorptiometry (DEXA) and examined serum adiponectin (ADP) levels at baseline and the end of the study.

RESULTS

There were no significant changes in the BMD of the L2-4, femoral neck, trochanter or total hip as well as in the BMC after 24 weeks of treatment with chiglitazar or sitagliptin. After chiglitazar administration, the FM, gynoid FM and gynoid to total FM ratio were higher, while the android to total FM ratio and the android to gynoid FM ratio (AOI) were significantly lower. Sitagliptin intervention did not result in statistically significant differences in total fat loss, but it did cause significant decreases in %BF and AOI as well as increases in the FFM, gynoid to total FM ratio and SMM. The ADP levels had significantly negative associations with AOI in all eligible patients.

CONCLUSION

The chiglitazar had no deleterious effects on BMD and resulted in body fat redistribution in untreated patients with T2DM.

TRIAL REGISTRATION

The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT02173457).

摘要

目的

评估未接受治疗的2型糖尿病(T2DM)患者在使用西格列他扎或西格列汀治疗前后骨矿物质密度(BMD)和身体成分的变化。

方法

总共81例T2DM患者被随机分为接受西格列他扎或西格列汀治疗24周(西格列他扎组54例,西格列汀组27例)。我们使用双能X线吸收法(DEXA)测量脊柱腰椎BMD、髋部BMD、脂肪量(FM)、去脂体重(FFM)、体脂百分比(%BF)、男性型FM、女性型FM和骨骼肌质量(SMM),并在基线和研究结束时检测血清脂联素(ADP)水平。

结果

使用西格列他扎或西格列汀治疗24周后,L2-4、股骨颈、大转子或全髋的BMD以及骨矿含量(BMC)均无显著变化。给予西格列他扎后,FM、女性型FM和女性型与总FM的比值较高,而男性型与总FM的比值以及男性型与女性型FM的比值(AOI)显著较低。西格列汀干预在总脂肪减少方面未产生统计学上的显著差异,但确实导致%BF和AOI显著降低,以及FFM、女性型与总FM的比值和SMM增加。在所有符合条件的患者中,ADP水平与AOI呈显著负相关。

结论

西格列他扎对BMD没有有害影响,并导致未接受治疗的T2DM患者身体脂肪重新分布。

试验注册

该试验在ClinicalTrials.gov注册(CT.gov标识符:NCT02173457)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00e9/10757783/009f042818f8/DMSO-16-4205-g0001.jpg

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