Observation of Liraglutide's Effect on Function of Pancreatic Islets β-Cell in Type 2 Diabetes
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摘要:
目的 观察GLP-1受体激动剂利拉鲁肽对初诊断2型糖尿病患者β细胞功能的影响。 方法 选择2020年3月至2021年3月在云南省第三人民医院内分泌科收治入院的新诊断2型糖尿病患者，随机分为试验组及对照组，试验组使用GLP-1受体激动剂利拉鲁肽治疗6月，对照组使用非GLP-1受体激动剂治疗6月（一联或二联方案）。观察和检测治疗前及治疗后3月、6月体重、BMI、FPG、2hPG、HbA1c、FINS、FC-P、HOMA-IR、HOMA-β的变化。 结果 92例患者纳入临床观察（试验组45例，对照组47例），与基线相比，治疗3月、6月后两组患者FPG、2hPG、HbA1c均显著下降 （P < 0.01），FINS、HOMA-IR、HOMA-β优于治疗前（P < 0.05），试验组BMI下降（P < 0.05），而对照组略有上升，但差异无统计学意义（P < 0.05）。与对照组相比，治疗6月后试验组较基线FPG、2hPG降幅更大，差异具有统计学意义（P < 0.05）；HbA1c有一定下降，差异无统计学意义（P > 0.05）。治疗3月、6月试验组FC-P均优于治疗前（P < 0.05），而对照组直到治疗6月结束时FC-P才优于治疗前（P < 0.05）。 结论 初诊断2型糖尿病尽早使用GLP-1类似物治疗较非GLP-1类似物方案可以有更优的修复β细胞功能作用、减轻体重、有效改善胰岛素抵抗。 Abstract:Objective To observe the effect of the GLP-1 receptor agonist liraglutide on β-cell function in patients newly diagnosed with type 2 diabetes patients. Methods Type 2 diabetes patients diagnosed between March 2020 and March 2021 in the Endocrinology Department of Yunnan Provincial Third People's Hospital were recruited and randomly divided into an experimental group and a control group. The experimental group was treated with liraglutide, a GLP-1 receptor agonist, for 6 months, while the control group received treatment with non-GLP-1 receptor agonists for 6 months （monotherapy or dual therapy）. Changes in Weight, BMI, FPG, PG, HbA1c, FINS, FC-P, HOMA-IR, and HOMA-β levels were observed and measured before treatment and at 3 and 6 months after treatment. Results A total of 92 patients were included in the clinical observation （45 in the experimental group and 47 in the control group）. Compared to baseline, both groups showed significant reductions in FPG, 2hPG, and HbA1c at 3 and 6 months after treatment （P < 0.01）. FINS, HOMA-IR, and HOMA-β improved compared to pre-treatment levels （P < 0.05）. BMI decreased in the experimental group （P < 0.05）, while it slightly increased in the control group, but the difference was not statistically significant （P > 0.05）. Compared to the control group, the experimental group showed a greater reduction in FPG and 2hPG from baseline after 6 months of treatment, with statistically significant differences （P < 0.05）. HbA1c showed a certain decrease, but the difference was not statistically significant （P > 0.05）. FC-P in the experimental group was superior to pre-treatment levels at both 3 and 6 months （P < 0.05）, while in the control group, FC-P was only improved at the end of 6 months of treatment （P < 0.05）. Conclusion Early use of GLP-1 analogs in the treatment of newly diagnosed type 2 diabetes, as opposed to non-GLP-1 analog regimens, can lead to better restoration of β-cell function, weight reduction, and effective improvment of insulin resistance. -
Key words:
- Type 2 Diabetes /
- Initial Diagnosis /
- Liraglutide /
- β Cellular Function
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图 1 两组血糖相关指标和胰岛功能指标对比。
A. 对比治疗组和对照组在基线、治疗3月和6个月时，血糖相关指标FPG、PG、HBAlc和BMI值；B. 对比治疗组和对照组在基线、治疗3月和6个月时，胰岛功能相关指标FINS、FC-P、HOMA-IR和HOMA-β值。BMI体重指数，FPG空腹血糖，PG餐后2小时血糖，HbA1c糖化血红蛋白，FINS空腹胰岛素，FC-P 空腹C肽，HOMA-IR胰岛素抵抗指数，HOMA-β胰岛β细胞功能指数。ns，无统计学差异；*P < 0.05，**P <0.01，***P < 0.001。
Figure 1. Comparison of blood glucose-related indicators and pancreatic function indicators between the two groups.
表 1 试验组与对照组临床资料.
Table 1. Clinical characteristics of the experimental and control groups.
项目 试验组 对照组 χ2/t P （N = 45） （N = 47） 性别（女/男） 14/31 21/26 1.80 0.18 年龄（岁） 45.85±2.81 46.43±2.08 1.17 0.24 体重（kg） 71.64±7.53 70.13±7.73 0.99 0.32 BMI（kg/m2） 26.57±1.94 26.47±1.83 0.27 0.79 FPG（mmol/L） 9.87±1.82 9.43±1.27 1.40 0.16 PG（mmol/L） 13.12±2.82 12.86±2.46 0.49 0.62 HbA1c（%） 9.05±1.22 8.63±1.24 1.71 0.09 FINS（uIU/mL） 10.85±3.78 11.12±3.39 0.38 0.71 FC-P（ng/mL） 2.32±1.24 2.51±1.53 0.68 0.50 HOMA-IR 4.58±0.78 4.86±0.76 1.81 0.07 HOMA-β 36.19±6.12 37.87±5.18 1.48 0.14 注：BMI体重指数；FPG空腹血糖；PG餐后2小时血糖；HBA1c糖化血红蛋白；FINS空腹胰岛素；FC-P 空腹C肽；HOMA−IR胰岛素抵抗指数；HOMA−β为胰岛β细胞功能指数。 
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