胰升血糖素样肽—1对肥胖糖代谢异常患者月经周期的调节作用及机制(1)
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(P<0.01﹚，但利拉鲁肽组优于二甲双胍组(P<0.05﹚；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(P<0.05﹚，LDL-c明显下降(P<0.01﹚，月经紊乱改善(P<0.01﹚，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
, http://www.100md.com
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(P<0.01)，but the result of the group of liraglutide is better than the group of metformin (P<0.05).In addition，in the group of liraglutide the improvements of the blood fat and the metformin are more obvious，the TG decreases(P<0.05)，the LDL-c decreases obviously(P<0.01)，and the menstrual disorder gets improvement(P<0.01)，the menalgia has release.Conclusion The conclusion of the study is that when the liraglutide is used to decrease the blood sugar and weight，meanwhile，it can improve the blood flat and release the resistance to the insulin，and then improves the menstrual disorder.
, 百拇医药
Keywords：Glucagon-like Peptide-1；Extrapancreatic effects；Obesity； Menstrual disorder
近20年來，中国人以令人膛目的速度迅速“胖”了起来。肥胖是糖尿病甚至是闭经、不孕的一个重要病因。胰高血糖素样肽-1(GLP-1)类似物的问世，为肥胖的2型糖尿病患者带来了新的希望，其不仅可降低空腹血糖(FPG)及餐后2h血糖(2hPG)，而且有显著减轻体重、抑制食欲及保护胰岛B细胞功能等多重作用。女性肥胖的糖代谢异常患者在进行降糖治疗的同时，不仅观察到体重的下降，还观察到了月经的改善。本文通过44例患者的观察，对其机理进行探讨。
1资料与方法
1.1一般资料 2013年7月～2015年1月在我院门诊及住院的女性肥胖的新诊断糖代谢异常患者，选取其中伴有月经紊乱的患者44例。本研究对象获得亭湖区人民医院伦理委员会批准，入选者均签署知情同意书。纳入标准：①符合1999年WHO糖代谢状态分类中空腹血糖受损(IFG)、糖耐量减低(IGT)及糖尿病(DM)的诊断标准。②18～55岁育龄女性，有月经紊乱(包括月经不规律、月经稀发、量少或闭经)。③体重指数(BMI)>25 kg/m2。④空腹血糖(FBG)<11.1 mmol/L，糖化血红蛋白(HbA1c)<9.0%。排除标准：①1型糖尿病，妊娠糖尿病，计划妊娠的、哺乳期糖尿病，其他类型糖尿病，糖尿病急性并发症。②肝肾功能异常，既往有急慢性胰腺炎，糖尿病胃轻瘫，使用过激素类药物者。③有肿瘤病史及家族史。④妇科检查子宫及双附件无异常。⑤所有病例经妇科B超及实验室检查除外妊娠及继发性肥胖。, http://www.100md.com(王绘 万丽丽 高玮)
关键词：胰升血糖素样肽-1；胰腺外作用；肥胖；月经紊乱
, http://www.100md.com
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(P<0.01)，but the result of the group of liraglutide is better than the group of metformin (P<0.05).In addition，in the group of liraglutide the improvements of the blood fat and the metformin are more obvious，the TG decreases(P<0.05)，the LDL-c decreases obviously(P<0.01)，and the menstrual disorder gets improvement(P<0.01)，the menalgia has release.Conclusion The conclusion of the study is that when the liraglutide is used to decrease the blood sugar and weight，meanwhile，it can improve the blood flat and release the resistance to the insulin，and then improves the menstrual disorder.
, 百拇医药
Keywords：Glucagon-like Peptide-1；Extrapancreatic effects；Obesity； Menstrual disorder
近20年來，中国人以令人膛目的速度迅速“胖”了起来。肥胖是糖尿病甚至是闭经、不孕的一个重要病因。胰高血糖素样肽-1(GLP-1)类似物的问世，为肥胖的2型糖尿病患者带来了新的希望，其不仅可降低空腹血糖(FPG)及餐后2h血糖(2hPG)，而且有显著减轻体重、抑制食欲及保护胰岛B细胞功能等多重作用。女性肥胖的糖代谢异常患者在进行降糖治疗的同时，不仅观察到体重的下降，还观察到了月经的改善。本文通过44例患者的观察，对其机理进行探讨。
1资料与方法
1.1一般资料 2013年7月～2015年1月在我院门诊及住院的女性肥胖的新诊断糖代谢异常患者，选取其中伴有月经紊乱的患者44例。本研究对象获得亭湖区人民医院伦理委员会批准，入选者均签署知情同意书。纳入标准：①符合1999年WHO糖代谢状态分类中空腹血糖受损(IFG)、糖耐量减低(IGT)及糖尿病(DM)的诊断标准。②18～55岁育龄女性，有月经紊乱(包括月经不规律、月经稀发、量少或闭经)。③体重指数(BMI)>25 kg/m2。④空腹血糖(FBG)<11.1 mmol/L，糖化血红蛋白(HbA1c)<9.0%。排除标准：①1型糖尿病，妊娠糖尿病，计划妊娠的、哺乳期糖尿病，其他类型糖尿病，糖尿病急性并发症。②肝肾功能异常，既往有急慢性胰腺炎，糖尿病胃轻瘫，使用过激素类药物者。③有肿瘤病史及家族史。④妇科检查子宫及双附件无异常。⑤所有病例经妇科B超及实验室检查除外妊娠及继发性肥胖。, http://www.100md.com(王绘 万丽丽 高玮)