[1]韦文合.达格列净联合唑来膦酸治疗老年糖尿病合并骨质疏松症疗效及对患者骨代谢、骨密度水平的影响[J].陕西医学杂志,2023,52(11):1574-1577,1592.[doi:DOI:10.3969/j.issn.1000-7377.2023.11.027]
 WEI Wenhe.Efficacy of dapagliflozin combined with zoledronic acid in treatment of elderly diabetic patients with osteoporosis and its effect on bone metabolism and bone mineral density[J].,2023,52(11):1574-1577,1592.[doi:DOI:10.3969/j.issn.1000-7377.2023.11.027]
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达格列净联合唑来膦酸治疗老年糖尿病合并骨质疏松症疗效及对患者骨代谢、骨密度水平的影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年11期
页码:
1574-1577,1592
栏目:
药物与临床
出版日期:
2023-11-05

文章信息/Info

Title:
Efficacy of dapagliflozin combined with zoledronic acid in treatment of elderly diabetic patients with osteoporosis and its effect on bone metabolism and bone mineral density
作者:
韦文合
(河池市人民医院内分泌科,广西 河池 547000)
Author(s):
WEI Wenhe
(Department of Endocrinology,Hechi People's Hospital,Hechi 547000,China)
关键词:
糖尿病 达格列净 唑来膦酸 二甲双胍 骨质疏松症 老年人
Keywords:
Diabetes Dapagliflozin Zoledronic acid Metformin Osteoporosis Aged
分类号:
R 587.1
DOI:
DOI:10.3969/j.issn.1000-7377.2023.11.027
文献标志码:
A
摘要:
目的:探讨达格列净联合唑来膦酸治疗老年糖尿病合并骨质疏松症疗效及对患者骨代谢、骨密度水平的影响。方法:选取60例老年糖尿病合并骨质疏松症患者,随机分成对照组与观察组,各30例。对照组接受二甲双胍联合唑来膦酸治疗,观察组在此基础上联合达格列净治疗。治疗6个月比较两组临床疗效、糖代谢、电解质、骨代谢及骨密度水平。结果:治疗6个月后,观察组血糖控制率、骨质疏松症治疗临床有效率均高于对照组(均P<0.05); 观察组空腹血糖、餐后2 h血糖、糖化血红蛋白及β-C-末端肽交联水平均显著低于对照组,血磷、钙、25羟基维生素D及Ⅰ型胶原N-段前肽均明显高于对照组(均P<0.05)。治疗6个月后,两组腰椎L2~4、Wards三角区、股骨颈、全髋部骨密度水平均上升(均P<0.05),但两组间比较差异无统计学意义(均P>0.05)。结论:老年糖尿病合并骨质疏松症患者应用达格列净联合唑来膦酸治疗在有效控制患者血糖的同时,能改善骨代谢,能增加骨密度,抑制骨吸收。
Abstract:
Objective:To investigate the efficacy of dapagliflozin combined with zoledronic acid in treatment of elderly diabetic patients with osteoporosis and its effect on bone metabolism and bone mineral density.Methods:A total of 60 elderly diabetic patients with osteoporosis were randomly divided into the control group and the observation group with 30 cases in each group.The control group was treated with metformin combined with zoledronic acid,while the observation group was treated with dapagliflozin on this basis.Six months later,the clinical curative effect,glucose metabolism,electrolytes,bone metabolism and bone mineral density were compared between groups.Results:After 6 months of treatment,the blood glucose control rate and clinical effective rate of osteoporosis treatment in the observation group were higher than those in the control group(all P<0.05); fasting blood glucose,2-hour postprandial blood glucose,glycosylated hemoglobin and β-C-terminal telopeptide in the observation group were lower than those in the control group,and serum phosphorus,serum calcium,25-hydroxyvitamin D,N-terminal propeptide of type I collagen were higher than those in the control group(all P<0.05); the BMD of lumbar L2-4,and Wards triangle,femoral neck,total hip in two groups were increased(all P<0.05),but there was no statistically significant difference between two groups(all P>0.05).Conclusion:Dapagliflozin combined with zoledronic acid in the treatment of elderly diabetic patients with osteoporosis can effectively control blood glucose,improve bone metabolism,increase bone mineral density,and inhibit bone resorption.

参考文献/References:

[1] 中国老年医学学会老年内分泌代谢分会,国家老年疾病临床医学研究中心(解放军总医院),中国老年糖尿病诊疗措施专家共识编写组.中国老年2型糖尿病诊疗措施专家共识(2018年版)[J].中华内科杂志,2018,57(9):626-641.
[2] Lzzo A,Massimino E,Riccardi G,et al.A narrative review on sarcopenia in type 2 diabetes mel litus:Prevalence and associated factors[J].Nutrients,2021,13(1):183.
[3] 廖 敏,谭 洁,吉 滔,等.补肾健骨汤对绝经后骨质疏松症患者骨代谢指标及性激素水平影响研究[J].陕西中医,2023,44(6):726-729.
[4] 史凡凡,赵继荣,马 同,等.中医药治疗糖尿病性骨质疏松症从“脾肾论治”机制[J].陕西中医,2022,43(5):604-607.
[5] 卢 燕,王晶璞,刘莉红.胰岛素联合唑来膦酸治疗老年糖尿病合并骨质疏松病人的疗效研究[J].实用老年医学,2019,33(6):565-568.
[6] 郭琼杰,安 迪,王克华,等.达格列净联合利拉鲁肽强化降糖治疗对二甲双胍治疗失效的2型糖尿病患者胰岛素抵抗、游离脂肪酸及过氧化物酶体激增物激活受体γ影响的研究[J].中国糖尿病杂志,2022,30(7):486-490.
[7] 赵 文,杨兴尧,林炎水.唑来膦酸联合二甲双胍对db/db小鼠骨质的影响[J].山东医药,2021,61(34):33-37.
[8] 王 敏,王 芳,张海云,等.西格列汀二甲双胍片联合唑来膦酸治疗2型糖尿病并发骨质疏松症的临床疗效观察[J].中国医学前沿杂志:电子版,2018,10(8):85-88.
[9] 中国老年学学会老年医学会老年内分泌代谢专业委员会,老年糖尿病诊疗措施专家共识编写组.老年糖尿病诊疗措施专家共识(2013年版)[J].中华内科杂志,2014,53(3):243-251.
[10] 中华医学会骨质疏松和骨矿盐疾病分会.原发性骨质疏松症诊疗指南(2017)[J].中华骨质疏松和骨矿盐疾病杂志,2017,10(5):413-443.
[11] 张振堂,赵枫琳,陈向华,等.青岛市黄岛区2型糖尿病患者规律服药率和血糖控制率规范管理干预效果评价[J].中国公共卫生,2019,35(11):1464-1466.
[12] 高 雷,张婷婷,牛 娜,等.阿法骨化醇治疗糖尿病性骨质疏松症临床研究[J].解放军医药杂志,2019,31(4):94-97.
[13] 金 浩,丰 磊,李丹丹,等.骨折风险预测简易工具对住院2型糖尿病患者骨折风险的预测及临床意义[J].中华骨质疏松和骨矿盐疾病杂志,2015,8(1):27-32.
[14] Mohsin S,Baniyas MM,AlDarmaki RS,et al.An update on therapies for the treatment of diabetes-induced osteoporosis[J].Expert Opin Biol Ther,2019,19(9):937-948.
[15] 李超杰,陈慧敏,濮先明.利拉鲁肽、格列美脲分别联用二甲双胍治疗肥胖型2型糖尿病疗效观察[J].陕西医学杂志,2021,50(3):356-358,373.
[16] Hu Q,Wang Q,Liu F,et al.Combination of calcitriol and zoledronic acid on P1NP and β-CTX in postoperative patients with diabetic osteoporosis:A randomized controlled trial[J].Dis Mar Kers,2022,2022:6053410.
[17] 李诗琦,陈 超,邢学农,等.达格列净对绝经后女性2型糖尿病患者血糖控制及骨密度的影响[J].中华骨质疏松和骨矿盐疾病杂志,2020,13(4):311-317.
[18] 侯士方.达格列净对2型糖尿病伴代谢综合征患者代谢指标的影响[J].山西医药杂志,2022,51(18):2105-2107.
[19] 刘 哲,刘易婷,王 晶.沙库巴曲缬沙坦联合达格列净治疗2型糖尿病合并心力衰竭临床疗效观察[J].陕西医学杂志,2022,51(3):355-358.
[20] 张 云,鲁 平.老年2型糖尿病患者合并骨质疏松的相关因素分析[J].中华老年医学杂志,2018,37(4):417-419.
[21] 陈清河,曾维铨,黄少辉,等.碳酸钙D3、骨化三醇联合唑来膦酸对2型糖尿病合并原发性骨质疏松症患者骨密度和骨痛的影响[J].中国骨质疏松杂志,2020,26(2):202-204,226.
[22] 牟伦盼,蒋建家,张雅萍,等.达格列净与利格列汀对口服降糖药控制不佳的超重或肥胖2型糖尿病患者的疗效和安全性比较[J].中华糖尿病杂志,2019,11(3):190-195.
[23] 张萌萌,张秀珍,邓伟民,等.骨代谢生化指标临床应用专家共识(2020)[J].中国骨质疏松杂志,2020,26(6):781-796.
[24] Wang JL,Cheng YZ,Yang SL,et al.Dapagliflozin attenuates hyperglycemia related osteoporosis in ZDF rats by alleviating hypercalciuria[J].Front Endocrinol(Lausanne),2019,10:700.

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备注/Memo

备注/Memo:
基金项目:广西壮族自治区卫生健康委员会自筹经费科研课题(Z20201032)
更新日期/Last Update: 2023-11-06