【摘要】 目的 探究二甲双胍和阿格列汀对2型糖尿病（T2DM）患者骨代谢、骨密度及血清脂肪细胞因子-13（Apelin-13）水平的影响，为T2DM患者的临床诊疗提供依据。方法 选取2019年8月至2020年8月就诊于保定市第一中心医院内分泌科的T2DM患者108例，按照随机数表法分为A组（采用二甲双胍联合阿卡波糖治疗）和B组（采用阿格列汀联合阿卡波糖治疗），每组54例，治疗48周。检测并比较两组患者治疗前及治疗48周后的血糖、骨代谢指标、Apelin-13水平和左侧股骨颈和L_1～4的骨密度（BMD）（采用双能X线骨密度仪测定）。结果 治疗48周后，两组患者的骨钙素（BGP）、总Ⅰ型胶原氨基端延长肽（TPINP）、Apelin-13水平及股骨颈和L_1～4的BMD均较治疗前升高，差异均有统计学意义（P<0.05），其中B组患者的TPINP、Apelin-13、股骨颈和L_1～4的BMD水平分别为（48.69±9.00） ng/m L、（2 210.53±376.20） pg/mL、（0.893±0.125） g/cm²、（1.042±0.092） g/cm²，明显高于A组的（43.52±8.17） ng/mL、（2 000.96±338.04） pg/mL、（0.841±0.110） g/cm²、（0.989±0.084） g/cm²，差异均有统计学意义（P<0.05），但治疗后A组和B组患者的BGP水平分别为（17.34±4.38） ng/mL、（17.73±4.96） ng/mL，差异无统计学意义（P>0.05）；治疗后，两组患者的Ⅰ型胶原羧基末端肽β特殊序列（β-CTX）水平较治疗前下降，差异均有统计学意义（P<0.05），其中B组患者的β-CTX水平为（329.73±96.07） pg/mL，明显低于A组的（366.21±89.28） pg/mL，差异有统计学意义（P<0.05）。结论 阿格列汀联合阿卡波糖在改善T2DM患者骨密度及调节骨代谢方面效果更好，并可有效升高Apelin-13水平。更多还原

【Abstract】 Objective To investigate the effect of alogliptin and metformin on bone metabolism index,bone mineral density,and serum adipocytokine Apelin-13 level in patients with type 2 diabetes mellitus （T2DM）,so as to provide evidence for clinical diagnosis and treatment of T2DM.Methods A total of 108 patients with T2DM who were admitted to the Department of Endocrinology,Baoding First Central Hospital from August 2019 to August 2020 were randomly divided into group A （treated with metformin combined with acarbose） and group B （treated with alogliptin combined with acarbose）,with 54 patients in each group,for 48 weeks.The blood glucose,bone metabolism indexes,Apelin-13 levels,and bone mineral density （BMD） of left femoral neck and lumbar spine_1～4were measured and compared between the two groups before and 48 weeks after treatment （measured by dual energy X-ray absorptiometry）.Results After 48 weeks of treatment,the levels of osteocalcin （BGP）,total type I collagen N-terminal elongation peptide （TPINP）,Apelin-13,and BMD of left femoral neck and lumbar spine 1-4 in the two groups were significantly higher than those before treatment （P<0.05）,and the levels of TPINP,Apelin-13,and BMD in group B were （48.69±9.00） ng/mL,（2 210.53±376.20） pg/mL,（0.895±0.130） g/cm²,（1.042±0.092） g/cm²,significantly higher than （43.52±8.17） ng/mL,（2 000.96±338.04） pg/mL,（0.841±0.110） g/cm²,（0.989±0.084） g/cm²in group A （P<0.05）;but the BGP levels in group A and B were （17.34±4.38） ng/mL and （17.73±4.96） ng/mL,respectively,and there was no significant difference （P>0.05）.After treatment,the levels ofβ-C-terminal cross-linked telpeptide （β-CTX） in the two groups decreased compared with those before treatment （P<0.05）,and the level ofβ-CTX in group B was （329.73±96.07） pg/mL,which was significantly lower than （366.21±89.28） pg/mL in group A （P<0.05）.Conclusion Alogliptin combined with acarbose has a better effect on improving bone mineral density and regulating bone metabolism in patients with type 2 diabetes mellitus,which can effectively increase Apelin-13 level.更多还原