目的 探讨利拉鲁肽对2型糖尿病(T2DM)合并肥胖患者血清趋化素和胰岛素抵抗(IR)的影响.方法 连续性收录80例肥胖T2DM患者,随机分为利拉鲁肽组(40例)和二甲双胍组(40例).分别于入组时和治疗后3个月检测血清趋化素水平和IR相关指标[稳态模型IR指数(HOM A-IR)、胰岛β细胞功能指数(HOM A-β)、胰岛素曲线下面积(INSAUC)、血糖曲线下面积(PGAUC),以及早期胰岛素分泌功能指数(ΔI30/ΔG30)].结果 经过3个月治疗后,利拉鲁肽组患者HOMA-IR、PGAUC和趋化素水平明显下降(P<0.05),HOMA-β和 ΔI30/ΔG30水平明显上升(P<0.05).组间比较可见,利拉鲁肽组患者HOMA-IR、PGAUC和趋化素水平明显低于二甲双胍组(P<0.05),而HOMA-β水平明显高于二甲双胍组(P<0.05).利拉鲁肽干预与ΔHOM A-IR和 Δ趋化素呈负相关(r分别为-0.665、-0.699,P<0.05),与 ΔHOM A-β(r=0.635,P<0.05)呈正相关.结论 利拉鲁肽干预治疗可能通过降低血清趋化素水平进而改善肥胖T2DM患者IR程度.%Objective To investigate the influence of liraglutide on serum chemerin level and insulin resistance in the patients with type 2 diabetes mellitus(T2DM ) complicating obesity .Methods Consecutive 80 T2DM patients with obesity were enrolled in this study and randomly divided into the liragluted group (n=40) and metformin group(n=40) .The serum chemerin level and IR related indexes were detected at the beginning of grouping and 3 months after treatment in the two groups ,including the homeosta-sis model assessment of insulin resistance(HOMA-IR) ,HOMA β cell function index(HOMA-β) ,area under the curve of insulin (INSAUC ) ,area under the curve of blood glucose(PGAUC ) and early insulin secretion index(ΔI30/ΔG30) .Results The levels of HO-MA-IR ,PGAUC and chemerin level after 3-months treatment in the liraglutide group were significantly decreased (P<0 .05) ,while HOMA-βand ΔI30/ΔG30 level were significantly increased(P<0 .05) .The comparison between the two groups showed that HO-MA-IR ,PGAUC and chemerin level in the liraglutide group were significantly lower than those in the metformin group (P<0 .05) , while the HOMA-βlevel was significantly higher than that in the metformin group(P<0 .05) .The liraglutide intervention was neg-atively correlated with ΔHOMA-IR and Δchemerin(r= -0 .665 ,-0 .699 ,P<0 .05) and positively correlated with ΔHOMA-β(r=0 .635 ,P<0 .05) .Conclusion The liraglutide intervention therapy may improve the IR degree in T 2DM patients with complicating obesity possibly by reducing serum chemerin levels .
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