个体化减重干预对肥胖合并T2DM患者体质量指数、糖脂代谢的影响

Effect of individual weight loss intervention on BMI, glucose, and lipid metabolism in obese patients with T2DM

摘要:

目的 探讨个体化减重干预对肥胖合并2型糖尿病（T2DM）患者体质量指数（BMI）、糖脂代谢的影响。方法 选取2019年1月—2019年12月连云港第一人民医院收治的90例肥胖合并T2DM患者，随机分为对照组和观察组，每组45例。均予以常规降糖药物治疗，对照组同时予以基础饮食、运动干预，观察组同时予以个体化减重干预，均持续3个月。比较两组利拉鲁肽用药剂量；检测并比较治疗前、治疗1个月后、治疗2个月后、治疗3个月后的BMI、糖脂代谢指标；比较两组治疗期间不良事件发生率。结果 两组利拉鲁肽用药剂量比较，差异无统计学意义（P >0.05）；观察组与对照组治疗前、治疗1个月后、治疗2个月后、治疗3个月后的BMI、空腹血糖（FBG）、餐后2小时血糖（2 hPG）、糖化血红蛋白（HbA1c）、胰岛素抵抗指数（HOMA-IR）、胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）比较，采用重复测量设计的方差分析，结果 ①不同时间点的BMI、FBG、2 hPG、HbA1c、HOMA-IR、TC、TG、LDL-C、HDL-C有差异（P <0.05）；②两组的BMI、FBG、2 hPG、HbA1c、HOMA-IR、TC、TG、LDL-C、HDL-C有差异（P <0.05），观察组BMI、FBG、2 hPG、HbA1c、HOMA-IR、TC、TG、LDL-C均低于对照组，观察组HDL-C高于对照组；③两组的BMI、FBG、2 hPG、HbA1c、HOMA-IR、TC、TG、LDL-C、HDL-C变化趋势有差异（P <0.05）。两组治疗期间不良事件发生率比较，差异无统计学意义（P >0.05）。结论 个体化减重干预可降低肥胖合并T2DM患者的BMI，调节糖脂代谢，且不良事件不会显著增多，相较于常规干预作用更大。

Abstract:

Objective To explore the effect of individual weight reduction intervention on body mass index (BMI) and glucose and lipid metabolism in obese patients with type 2 diabetes mellitus (T2DM).Methods Ninety obese patients with T2DM were randomly divided into two groups, who were treated with conventional hypoglycemic drugs. The control group received basic diet and exercise intervention at the same time, while the observation group received individual weight reduction intervention, all lasted for 3 months. The dosage of liraglutide and the changes of BMI and glycolipid metabolism indexes before treatment, 1 month, 2 months and 3 months and after treatment, and the incidences of adverse events during intervention were compared.Results There was no significant difference in the dosage of liraglutide between the two groups (P > 0.05). Compared with the BMI, fasting blood glucose (FBG), 2 h postprandial blood glucose (2 hPG), glycosylated hemoglobin (HbA1c), insulin resistance index (HOMA-IR), cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C) between the observation group and the control group before treatment, after 1 month, 2 months and 3 months of treatment by analysis of variance with repeated measurement data, and the results showed that there were differences in the BMI, FBG, 2 hPG, HbA1c, HOMA-IR, TC, TG, LDL-C, and HDL-C among different moments (P < 0.05). There were differences in the BMI, FBG, 2 hPG, HbA1c, HOMA-IR, TC, TG, LDL-C, and HDL-C between the observation group and the control group (P < 0.05), among which the BMI, FBG, 2 hPG, HbA1c, HOMA-IR, TC, TG, LDL-C levels in the observation group were lower than those in the control group, while the HDL-C levels in the observation group were higher than those in the control group. There were differences in the change trends of BMI, FBG, 2 hPG, HbA1c, HOMA-IR, TC, TG, LDL-C, and HDL-C between the observation group and the control group (P < 0.05). There was no statistically significant difference in the incidences of adverse events during intervention (P > 0.05).Conclusion Individual weight reduction intervention can reduce BMI and regulate glucose and lipid metabolism in patients with obesity and T2DM, without significantly increasing adverse events, which is better than conventional intervention.