目的 观察老年2型糖尿病患者经利拉鲁肽治疗后胰岛素样生长因子1(IGF-1)及胰岛素样生长因子1受体(IGF-1R)的表达变化情况,以探讨利拉鲁肽治疗老年2型糖尿病的价值。方法 选取2017年1月-2019年2月期间于我院门诊82例老年2型糖尿病患者,采用数字奇偶法将入选者分为观察组(奇数)与对照组(偶数),各41例。所有入选者均接受常规治疗并联合使用二甲双胍,在此基础上为观察组患者联合利拉鲁肽治疗,均治疗6个月；分别于治疗前、治疗6个月后检测并比较两组IGF-1及IGF-1R水平、记录两组身体质量指数(BMI)及腰围并比较、检测并比较两组胰岛功能[空腹C肽(FC-P)、餐后两小时C肽(2hC-P)]、脂联素及抵抗素水平；治疗期间记录并比较两组不良反应发生情况。结果 治疗6个月后,两组IGF-1及IGF-1R水平均较治疗前降低,且观察组各水平均低于对照组,差异有统计学意义(P＜0.05)；治疗6个月后,对照组BMI、腰围、FC-P水平、2hC-P、胰岛素抵抗指数(HOMA-IR)水平、脂联素水平、抵抗素水平较治疗前无明显变化,各指标组内比较差异无统计学意义(P＞0.05)；治疗6个月后,观察组BMI值、抵抗素水平较治疗前降低、腰围较治疗前缩小,FC-P、2hC-P、HOMA-IR、脂联素水平均较治疗前升高,且BMI、抵抗素水平低于对照组、腰围小于对照组、FC-P、2hC-P、HOMA-IR、脂联素水平均高于对照组,差异有统计学意义(P＜0.05)；治疗期间组间不良反应发生率比较差异无统计学意义(P＞0.05)。结论 老年2型糖尿病患者经利拉鲁肽治疗获益明显,患者外周血IGF-1及IGF-1R水平明显改善,有利于调节患者胰岛功能、降低BMI、缩小腰围,患者脂联素、抵抗素水平显著改善,临床应用价值高。

Objective To observe the effect of liraglutide on insulin-like growth factor 1 (IGF-1) and insulin-like growth factor 1 receptor (IGF-1R) expression in senile patients with type 2 diabetes mellitus (T2DM), and to investigate the value of liraglutide in treatment of senile T2DM. Methods 82 senile patients with T2DM in the outpatient from January 2017 to February 2019 were selected, and they were divided into observation group (odd numbers) and control group (even numbers) according to digital parity method, with 41 cases in each group. All selected cases underwent conventional treatment combined with metformin, and based on this, the patients in observation group were treated with liraglutide for 6 months; The levels of IGF-1 and IGF-1R before treatment and after treatment for 6 months were detected and compared between two groups, the body mass index (BMI) and waist circumference in two groups were recorded, and the islet function [fasting C peptide ( FC-P), 2 hours postprandial C-peptide (2hC-P)], adiponectin and resistin levels in two hours were detected and compared; The incidence of adverse reactions in two groups was recorded and compared between the two groups during treatment. Results After 6 months of treatment, the levels of IGF-1 and IGF-1R in the two groups were lower than before treatment, and the levels in observation group were lower than those in control group (P<0.05); After 6 months of treatment, the BMI, waist circumference, FC-P, 2hC-P, Insulin Resistance Index (HOMA-IR), adiponectin, and resistin levels in control group had no significant changes than before treatment, and there was no statistically significant difference in the indexes among the groups (P>0.05); After 6 months of treatment, the BMI and resistin level in observation group were lower than those before treatment, the waist circumference was smaller than that before treatment, the levels of FC-P, 2hC-P, HOMA-IR and adiponectin were higher than those before treatment, the BMI and resistin level in observation group were lower than those in control group, the waist circumference in observation group was smaller than that in control group, and the levels of FC-P, 2hC-P, HOMA-IR and adiponectin in observation group were higher than those in control group (P<0.05); There was no statistical difference in the incidence of adverse reactions between groups during treatment (P>0.05). Conclusion Liraglutide in treatment of senile patients with T2DM has significant benefits. The peripheral blood IGF-1 and IGF-1R levels are significantly improved, which is conducive to regulating islet function, decreasing BMI, reducing waist circumference, and improving adiponectin and resistin levels, with high clinical application value.