2024 年第 1 期 第 19 卷

利拉鲁肽联合阿托伐他汀对肥胖2型糖尿病患者血糖和脂肪因子及肠道菌群的影响

Effects of liraglutide combined with atorvastatin on blood glucose, adipokines and intestinal flora in obese patients with type 2 diabetes mellitus

作者：李敏 高瑞超 张志佳 刘旋 童玉环 檀增桓 杨力

英文作者：Li Min Gao Ruichao Zhang Zhijia Liu Xuan Tong Yuhuan Tan Zenghuan Yang Li

单位：河北省邯郸市中心医院内分泌二科，邯郸056000

英文单位：The Second Department of Endocrinology Handan Central Hospital Hebei Province Handan 056000 China

关键词：2型糖尿病；肥胖；利拉鲁肽；阿托伐他汀；血糖；脂肪因子；肠道菌群

英文关键词：Type2diabetesellitus;Obesity;Liraglutide;Atorvastatin;Bloodglucose;Adipokines;Intestinalflora

• 摘要：

• 目的  探讨利拉鲁肽联合阿托伐他汀对肥胖2型糖尿病（T2DM）患者血糖、脂肪因子及肠道菌群的影响。方法  应用电脑随机数字表法将2019年1月至2021年1月河北省邯郸市中心医院收治的132例肥胖T2DM患者分为观察组、对照组，各66例。2组均给予常规治疗，在此基础上，对照组给予阿托伐他汀治疗，观察组给予阿托伐他汀联合利拉鲁肽治疗，2组疗程均为6个月。比较2组治疗前后空腹血糖、糖化血红蛋白（HbA1c）、餐后2 h血糖（2 hPG）、体重指数、腰围、腰臀比、脂肪因子［抵抗素、瘦素、内脂素、脂联素、摄食抑制因子1（Nesfatin-1）］、肠道菌群水平及不良反应发生情况。结果  治疗后，观察组空腹血糖、2 hPG、HbA1c、体重指数、腰围、腰臀比、抵抗素、瘦素、内脂素均低于对照组，脂联素、Nesfatin-1高于对照组（均P＜0.05）。治疗后，观察组肠杆菌、肠球菌均低于治疗前和对照组，酵母菌、双歧杆菌、乳杆菌均高于治疗前和对照组（均P＜0.05）。观察组不良反应发生率与对照组比较［10.6%（7/66）比6.1%（4/66）］，差异无统计学意义（P=0.345）。结论  利拉鲁肽联合阿托伐他汀治疗肥胖T2DM，可有效降低血糖，改善脂肪代谢及肠道菌群，并能降低体重指数、腰围、腰臀比，安全可靠。

• Objective  To investigate the effect of liraglutide combined with atorvastatin on blood glucose, adipokines and intestinal flora in obese patients with type 2 diabetes mellitus (T2DM). Methods  The computerized random number table method was applied to divide 132 obese T2DM patients admitted to Handan Central Hospital, Hebei Province from January 2019 to January 2021 into the observation group and the control group, with 66 cases in each group. Both groups were given conventional treatment, based on which the control group was given atorvastatin and the observation group was given atorvastatin combined with liraglutide. The duration of treatment was 6 months in both groups. The fasting blood glucose (FBG), glycated haemoglobin (HbA1c), 2 h postprandial blood glucose (2 hPG), body mass index, waist circumference, waist-to-hip ratio, adipokines ［resistin, leptin, visfatin, adiponectin and fatinfluencing protein-1 (Nesfatin-1)］, intestinal flora and occurrence of adverse reactions were compared between two groups. Results  After treatment, FBG, 2 hPG, HbA1c, body mass index, waist circumference, waist-to-hip ratio, resistin, leptin, and visfatin in the observation group were lower than those in the control group, while adiponectin and Nesfatin-1 were higher than those in the control group (all P＜0.05). After treatment, Enterobacteriaceae and Enterococcus in the observation group were lower than those before treatment and in the control group, while Yeast, Bifidobacteria and Lactobacillus were higher than those before treatment and in the control group (all P＜0.05). There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group ［10.6%(7/66) vs 6.1%(4/66)］(P=0.345). Conclusion  Liraglutide combined with atorvastatin in the treatment of obese T2DM can improve glucose metabolism, adipokines and intestinal flora, reduce body mass index, waist circumference, waist-to-hip ratio, and is safe and reliable.