浙江医学2017，Vol.39Issue(16)：1328-1332,5.DOI:10.12056/j.issn.1006-2785.2017.39.16.2017-323
二甲双胍和西格列汀对绝经后2型糖尿病患者骨代谢的影响
Effects of metformin and sitagliptin on bone metabolism in postmenopausal patients with type 2 diabetes
摘要
Abstract
Objective To evaluate the effect of metformin and sitagliptin on bone mineral density (BMD) and bone turnover biomarkers in type 2 diabetic postmenopausal patients with osteoporosis or osteopenia.Methods One hundred and twenty nine type 2 diabetic postmenopausal patients with osteoporosis or osteopenia were randomly assigned to three groups:treated with glipizide (G group,n=43),sitagliptin+glipizide (S+G group,n=43) or metformin+glipizide (M+G group,n=43) for 48 weeks,respectively.Fasting blood samples were collected for measurement of fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),low-density lipoprotein cholesterol (LDL-C),serum phosphatase (ALP),osteocalcin (OC),and β-C-terminal cross-linked telpeptide (β-CTX) which were measured at baseline and at the end of the study.BMD of femoral neck and hip were measured by dual energy X-ray absorptiometry at baseline and the end of study.Results One hundred and twenty two of 129 patients completed the 48-week intervention,including 40 in G group,41 in S+G group and 41 in M+G group,respectively.The mean values of three groups at the end of the study for BMI,OC,β-CTX,BMD of femoral neck and hip were sighificantly different (all P＜0.05).The mean values of FBG and HbA1c were significantly decreased at the end of study in three groups compared to baseline values (both P＜0.01).The mean BMI after treatment was significantly decreased in M+G group compared to baseline (P＜0.01).The mean serum OC was significantly decreased in G and S+G groups after treatment(both P＜0.01).The mean serum β-CTX was significantly decreased in S+G group (P＜0.01).The mean BMD of femoral neck and hip were significantly decreased in G group (both P＜0.01).Conclusion Sitagliptin has anti-osteoporotic and partially osteogenic effect,while metformin has osteogenic effect,and both can be used as the first line drugs for diabetic postmenopausal women with osteoporosis or osteopenia.关键词
骨质疏松/骨转换/糖尿病/二甲双胍/西格列汀Key words
Osteoporosis/Bone turnover/Diabetes/Metformin/Sitagliptin引用本文复制引用
杨迪,沈洁,李晓林,赵瑜,朱丹杰,邹成,冯法博..二甲双胍和西格列汀对绝经后2型糖尿病患者骨代谢的影响[J].浙江医学,2017,39(16):1328-1332,5.基金项目
浙江省医药卫生科技计划项目(2014KYA023) （2014KYA023）
