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. 2023 Mar 20;43(3):436-442.
doi: 10.12122/j.issn.1673-4254.2023.03.14.

[Comparison of therapeutic effect of metformin hydrochloride/vildagliptin and liraglutide on type 2 diabetes mellitus in obese patients]

[Article in Chinese]
Affiliations

[Comparison of therapeutic effect of metformin hydrochloride/vildagliptin and liraglutide on type 2 diabetes mellitus in obese patients]

[Article in Chinese]
B Zhou et al. Nan Fang Yi Ke Da Xue Xue Bao. .

Abstract

Objective: To evaluate the therapeutic effects of two therapeutic strategies based on metformin hydrochloride/vildagliptin and liraglutide on type 2 diabetes mellitus (T2DM) in obese patients.

Methods: We retrospectively collected the clinical data of 107 obese patients (BMI>25 kg/m2) with T2DM treated in Second Affiliated Hospital of Wannan Medical College (Wuhu, China) during 2019-2021, including 53 patients treated continuously with metformin hydrochloride/vildagliptin and 54 with liraglutide for 3 months. The changes in BMI, waist circumference, fasting blood glucose (FBG), postprandial blood glucose, HbA1C, fasting C-peptide, postprandial C-peptide, fasting insulin and postprandial insulin of the patients after treatment were compared between the two groups.

Results: In both of the groups, the patients all showed significant reductions of BMI, waist circumference, FBG, postprandial blood glucose and HbA1C (all P < 0.05) with improved fasting and postprandial C-peptide levels after the treatments (P < 0.05). The two treatment regimens showed comparable blood glucoselowering effects, but liraglutide produced better effect in reducing waist circumference (P < 0.01). Neither of two regimens obviously affected insulin level of the patients (P>0.05).

Conclusion: Both metformin hydrochloride/vildagliptin and liraglutide have good therapeutic effects on T2DM in obese patients and can achieve good blood glucose and weight control, but liraglutide has a better effect for weight control.

目的: 评价基于二甲双胍/维格列汀和利拉鲁肽的两种治疗方案对肥胖合并2型糖尿病患者(BMI>25 kg/m2)的临床疗效。

方法: 回顾性分析2019~2022年皖南地区107例肥胖合并2型糖尿病患者,根据所选患者初发肥胖合并2型糖尿病,将患者分为二甲双胍/维格列汀治疗组(n=53)和利拉鲁肽治疗组(n=54),持续治疗3个月。比较两组患者治疗前后的BMI、腹围、空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹C肽、餐后2 hC肽、空腹胰岛素及餐后2 h胰岛素,观察治疗前后各项指标的变化。

结果: 107例皖南地区肥胖合并2型糖尿病患者中,二甲双胍/维格列汀组和利拉鲁肽组患者治疗前后的BMI(P < 0.05)、腹围(P < 0.05)、空腹血糖(P < 0.05)、餐后2 h血糖(P < 0.05)以及糖化血红蛋白(P < 0.05)均较前下降,空腹C肽及餐后2 hC肽较前恢复(P < 0.05)。对比两组治疗结果,血糖下降水平疗效相当,但利拉鲁肽组的腹围减少疗效更优(P < 0.01),两组治疗方案对患者的胰岛素水平影响并不显著(P>0.05)。

结论: 二甲双胍/维格列汀和利拉鲁肽作为新型降糖药物,对于肥胖合并2型糖尿病具有很好疗效,可以控制血糖、减轻体质量,但利拉鲁肽对患者体质量的控制效果相对更佳。

Keywords: liraglutide; metformin hydrochloride/vildagliptin; obesity; type 2 diabetes mellitus.

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Figures

图 1
图 1
二甲双胍维格列汀组BMI、腹围、空腹血糖及餐后C肽对糖化变化的相关性 Correlations of the changes in BMI, waist circumference, FBG and 2h CP with those of HbA1C in metformin/vildagliptin group.
图 2
图 2
利拉鲁肽组空腹血糖及餐后血糖对糖化变化的相关性 Correlations of the changes in BMI, waist circumference, FBG and 2h CP with those of HbA1C in liraglutide group.

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