【摘要】 目的 观察利拉鲁肽对男性T2DM合并骨质疏松(OP)患者的治疗作用。方法 研究病例均选自2018至2019年在我科住院的T2DM患者，其中合并骨质疏松患者(OP组)68例，不合并骨质疏松的患者60例，分别就两组患者病程、年龄、糖化血红蛋白、血脂、骨代谢指标及BMD水平进行差异性比较；然后将OP组患者就治疗前、治疗12周及停药12周的骨代谢、骨密度进行研究比较。结果 (1)OP组BMI、HbA1c、TC、TG、LDL、PTH、OC、TP1NP、β-CTX较T2DM组升高，BMD降低；(2)男性T2DM合并骨质疏松患者应用利拉鲁肽12周后，其BMI、HbA1c、LDL、TG、TP1NP、β-CTX均降低，25-OH-D、BMD升高；利拉鲁肽停止使用12周即研究结束时，OP组患者的TP1NP、HbA1c较停药前有所上升，而BMD则呈下降趋势；(3)OP组治疗12周时与对照组比较，HbA1c无明显差异，但LDL、TP1NP水平下降，25羟维生素D、BMD则上升，OP组BMI值与T2DM组差异缩小，肥胖程度改善。结论 利拉鲁肽除了有其良好的降糖效果，同时对体重管控及调节血脂均有益处，而且可以提高骨密度，并且这种对骨质的改善作用是独立于血糖血脂控制带来的骨质改善作用之外的，对于2型糖尿病合并骨质疏松症的患者能够双效治疗，可作为糖尿病合并骨质疏松症患者首选推荐用药，既能改善血糖血脂、管理体重，还能增加骨密度。更多还原

【Abstract】 Objective To observe the therapeutic effect of liraglutide on male T2 DM patients with osteoporosis(OP). MethodsAll the cases were selected from T2 DM patients who were hospitalized in our department in 2018 and 2019, including 68 patients with osteoporosis(OP group) and 60 patients without osteoporosis(T2 DM group). The course of disease, age, glycosylated hemoglobin, blood lipids(TC, TG, HDL, LDL), bone metabolism indicators(25 hydroxyvitamin D,parathyroid hormone, osteocalcin, TP1 NP, osteocalcin, etc. Then compare the bone metabolism and bone mineral density of patients in OP group before treatment, after treatment for 12 weeks and after stopping treatment for 12 weeks. Results(1) BMI, HbA1 c, TC, TG, LDL, PTH, OC, TP1 NP and β-CTX in OP group were higher than those in T2 DM group, while BMD was lower.(2) After taking liraglutide for 12 weeks, BMI, HbA1 c, LDL, TG, TP1 NP and β-CTX decreased, while 25-OH-D and BMD increased in male T2 DM patients with osteoporosis(OP). At the end of the study, when liraglutide was stopped for 12 weeks, the TP1 NP and HbA1 c of patients in OP group increased compared with those before stopping, while BMD showed a downward trend.(3) Compared with the control group, there was no significant difference in HbA1 c in the OP group after 12 weeks of treatment, but the levels of LDL and TP1 NP decreased, while the levels of 25-hydroxyvitamin D and BMD increased. The difference of BMI between the OP group and T2 DM group decreased, and the degree of obesity improved. Conclusion Liraglutide not only has a particularly good hypoglycemic effect, but also is beneficial to weight control and blood lipid regulation, and can improve bone density. Besides, its bone improvement effect is independent of that brought by blood glucose and blood lipid control, and It can be used as the first choice and recommended drug for diabetic patients with osteoporosis, which can not only improve blood sugar and blood lipid, manage body weight, but also increase bone density.更多还原