胰升血糖素样肽―1对肥胖糖代谢异常患者月经周期调节作用及机制.docVIP

胰升血糖素样肽―1对肥胖糖代谢异常患者月经周期调节作用及机制 　　摘要：目的 观察胰升血糖素样肽-1在降糖、降体重治疗的同时所带来的额外获益即胰腺外作用，对月经周期的影响。方法 新诊断的女性肥胖的糖代谢异常患者，选取其中伴有月经紊乱的患者44例，随机分为利拉鲁肽组及二甲双胍组。利拉鲁肽组睡前皮下注射利拉鲁肽0.6 mg/d，1 w后增至1.2 mg。二甲双胍组口服二甲双胍0.25 tid，1 w后加量至0.5 tid。观察两组治疗前后血糖、血脂、BMI、HOMA-IR及月经紊乱的改善情况。结果 两组在12 w的治疗后，FBG、HbA1c、BMI、HOMA-IR都得到明显的改善（P0.01?w，但利拉鲁肽组优于二甲双胍组（P0.05?w；除此以外，利拉鲁肽组在血脂及月经紊乱方面有着更为明显的改善，TG下降（P0.05?w，LDL-c明显下降（P0.01?w，月经紊乱改善（P0.01?w，痛经缓解。结论 利拉鲁肽在降糖、降体重的同时，还能改善血脂，缓解胰岛素抵抗，进而改善月经紊乱。 　　关键词：胰升血糖素样肽-1；胰腺外作用；肥胖；月经紊乱 　　Abstract：Objective This study mainly focuses on observing the influences that the extrapancreatic effects has on menstrual cycle，which are the extra benefits of the glucagon-like peptide-1 when it is used for the cure of decreasing the blood sugar and the weight.Methods From the hyperpimelic women whose are diagnosed as having abnormal glycometabolism，the study selects 44 women whose also have the menstrual disorder.And they are randomly divided into two groups，one is called liraglutide group and the other is called metformin group.In the group of liraglutide，each of them is injected 0.6mg liraglutide under the skin before sleep every day，and the dosage is added to 1.2 mg one week later.Meanwhile，in the group of metformin，each patient take 0.25tid metformin orally，and the dosage is added to 0.5tid one week later.And then，for the two groups，we will observe the improvement of the blood sugar，the blood fat，the BMI，the HOMA-IR and the menstrual disorder before and after the treatment.Results After 12 weeks of the cure for the two groups，FBG，HbAlc，BMI and HOMA-IR gets great improvements（P0.01），but the result of the group of liraglutide is better than the group of metformin （P0.05）.In addition，in the group of liraglutide the improvements of the blood fat and the metformin are more obvious，the TG decreases（P0.05），the LDL-c decreases obviously（P0.01），and the menstrual disorder gets improvement（P0.01），the menalgia has release.Conclusion The conclusion of the study is that when the liraglutide is used t