利拉鲁肽联合二甲双胍对超重/肥胖型2型糖尿病患者糖脂代谢水平和颈动脉内膜中层厚度的影响

doi:10.12092/j.issn.1009-2501.2026.05.006

中国临床药理学与治疗学 ›› 2026, Vol. 31 ›› Issue (5): 623-630.doi: 10.12092/j.issn.1009-2501.2026.05.006

利拉鲁肽联合二甲双胍对超重/肥胖型2型糖尿病患者糖脂代谢水平和颈动脉内膜中层厚度的影响

程梅¹(), 方朝晖¹^,²^,³^,*(), 赵进东¹, 盛凤霞¹, 马梦楠¹

1. 安徽中医药大学第一附属医院内分泌科，合肥 230031，安徽
2. 安徽省中医药科学院中医药防治糖尿病研究所，合肥 230031，安徽
3. 合肥综合性国家科学中心大健康研究院新安医学与中医药现代化研究所，合肥 230012，安徽

收稿日期:2025-09-13 修回日期:2026-02-11 出版日期:2026-05-26 发布日期:2026-06-02
通讯作者: 方朝晖 E-mail:1213597466@qq.com;fangzhaohui9097@163.com
作者简介:程梅，女，本科，副主任护师，研究方向：内分泌代谢疾病中西医结合护理。E-mail：1213597466@qq.com
基金资助:
国家中医内分泌优势专科建设项目（2025-1382）；2023年中央财政转移支付地方项目：国中医药科技中药便函[2023]24号；国家自然科学基金项目（82174153）；国家重点研发计划课题（2018YFC1704202）；合肥综合性国家科学中心大健康研究院新安医学与中医药现代化研究所“揭榜挂帅”项目（2023CXMMTCM003）；合肥综合性国家科学中心大健康研究院新安医学与中医药现代化研究所“揭榜挂帅”项目（2023CXMMTCM024）；安徽中医药大学校级科学研究项目（2020yfyzc66）

Liraglutide combined with metformin on glycolipid metabolism level and intima-media thickness in overweight/obese patients with type 2 diabetes mellitus

Mei CHENG¹(), Zhaohui FANG¹^,²^,³^,*(), Jindong ZHAO¹, Fengxia SHENG¹, Mengnan MA¹

1. Department of Endocrinology, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei 230031, Anhui, China
2. Institute of Diabetes Prevention and Treatment of Traditional Chinese Medicine, Anhui Academy of Chinese Medicine, Hefei 230031, Anhui, China
3. Institute of Xin'an Medicine and Modernization of Traditional Chinese Medicine, Hefei Comprehensive National Science Center-Institute of Health and Medicine, Hefei 230012, Anhui, China

Received:2025-09-13 Revised:2026-02-11 Online:2026-05-26 Published:2026-06-02
Contact: Zhaohui FANG E-mail:1213597466@qq.com;fangzhaohui9097@163.com

摘要/Abstract

摘要：

目的: 探讨利拉鲁肽联合二甲双胍在超重/肥胖型2型糖尿病（type 2 diabetes mellitus，T2DM）患者中的临床应用效果。方法: 选取安徽中医药大学第一附属医院内分泌科收治的140例超重/肥胖型T2DM住院患者，采用随机数字表将研究对象分为对照组和观察组，每组各70例。对照组采用二甲双胍治疗和糖尿病常规诊疗，观察组在此基础上增加利拉鲁肽皮下注射。比较两组治疗12周后糖脂代谢水平、颈动脉内膜中层厚度（intima-media thickness，IMT）、体质量指数（body mass index，BMI）、腰围和臀围的控制情况。通过糖尿病特异性生活质量量表（diabetes-specific quality of life，DSQL）来评估患者生活质量。结果: 经12周干预后，与治疗前相比，观察组和对照组糖脂代谢指标及IMT均有显著改善（P<0.05），且观察组改善程度优于对照组。与治疗前相比，两组DSQL评分均有明显下降（P<0.05），且观察组改善情况明显优于对照组（P<0.05）。此外，与治疗前相比，两组患者的体质量、BMI、腰围也有明显改善（P<0.05），且观察组改善患者肥胖/超重水平优于对照组。治疗过程中，两组不良反应发生率无明显差异（P>0.05）。结论: 与单用二甲双胍相比，联合利拉鲁肽治疗可有效改善超重/肥胖型T2DM患者的糖脂代谢指标，降低颈动脉IMT，减缓动脉粥样硬化的进展，提高患者的生活质量，且不增加不良反应发生率，为临床治疗提供了新的思路和方法。

关键词: 利拉鲁肽, 二甲双胍, 超重/肥胖型T2DM, 糖脂代谢, 颈动脉内膜中层厚度, 生活质量

Abstract:

AIM: To investigate the clinical efficacy of liraglutide combined with metformin in overweight/obese patients with type 2 diabetes mellitus (T2DM). METHODS: A total of 140 overweight/obese patients with T2DM admitted to the Department of Endocrinology of the First Affiliated Hospital of Anhui University Traditional Chinese Medicine were randomly divided into control group and observation group, with 70 cases in each. The control group was treated with metformin and routine diabetes diagnosis and treatment, and the observation group was treated with subcutaneous injection of liraglutide. The levels of glycolipid metabolism, carotid artery intima-media thickness (IMT), body mass index (BMI), and waist circumference (WC) and hip circumference (HC) were compared between the two groups after 12 weeks of treatment. The quality of life of patients was evaluated by Diabetes-Specific Quality of Life (DSQL). RESULTS: After 12 weeks of intervention, FPG, 2hPG, HbA1c, TC, TG, HDL-C, LDL-C and IMT in both the observation and control groups were significantly improved compared with those before treatment (P<0.05), and the observation group showed a better improvement than the control group. Although a statistically significant decrease in DSQL scores was evident in both groups after treatment (P<0.05), the improvement was significantly greater in the observation group than in the control group (P<0.05). In addition, after treatment, the weights, BMI, and WC and HC of the patients in both groups were significantly improved compared with those before treatment (P<0.05), and the group showed a better improvement in the level of obesity/overweight than the control group. During the treatment, the comparison of safety profiles revealed a similar incidence of adverse reactions between the two groups (P<0.05). CONCLUSION: Liraglutide combined with metformin can effectively improve the glycolipid metabolism of overweight/obese patients with type 2 diabetes, reduce carotid artery IMT, slow down the progression of atherosclerosis, improve the quality of life of patients, and does not increase incidence of adverse reactions, which provides new ideas and methods for clinical treatment.

Key words: liraglutide, metformin, overweight/obesity type 2 diabetes mellitus, glycolipid metabolism, carotid arteryima-media thickness, quality of life

中图分类号:

R587.1

程梅, 方朝晖, 赵进东, 盛凤霞, 马梦楠. 利拉鲁肽联合二甲双胍对超重/肥胖型2型糖尿病患者糖脂代谢水平和颈动脉内膜中层厚度的影响[J]. 中国临床药理学与治疗学, 2026, 31(5): 623-630.

Mei CHENG, Zhaohui FANG, Jindong ZHAO, Fengxia SHENG, Mengnan MA. Liraglutide combined with metformin on glycolipid metabolism level and intima-media thickness in overweight/obese patients with type 2 diabetes mellitus[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(5): 623-630.

图/表 6

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Item	Control (n=70)	Treatment (n=70)
Gender (male/female)	47/23	44/26
Age/year	50.48±14.08	51.34±12.52
BMI (kg/m²)	30.92±1.76	30.86±1.68
HR (time/min)	84.23±6.28	85.28±6.26
SBP (mmHg)	138.56±7.28	137.68±7.28
DBP (mmHg)	78.68±6.84	77.82±8.46

Item	Control (n=70)	Treatment (n=70)
Gender (male/female)	47/23	44/26
Age/year	50.48±14.08	51.34±12.52
BMI (kg/m²)	30.92±1.76	30.86±1.68
HR (time/min)	84.23±6.28	85.28±6.26
SBP (mmHg)	138.56±7.28	137.68±7.28
DBP (mmHg)	78.68±6.84	77.82±8.46

Item	FPG (mmol/L)		2hPG (mmol/L)		HbA1c (%)
Item	Before treatment	After treatment	Before treatment	After treatment	Before treatment	After treatment
Control	9.32±1.85	8.75±1.24	12.48±3.26	10.75±1.86	10.36±1.18	8.64±1.36
Treatment	9.30±1.76	6.72±1.36	12.30±2.36	6.58±1.58	10.24±1.25	6.50±1.52
t	0.049	6.976	0.283	3.216	0.182	12.02
P	0.960	0.000	0.7140	0.000	0.857	0.000

Item	FPG (mmol/L)		2hPG (mmol/L)		HbA1c (%)
Item	Before treatment	After treatment	Before treatment	After treatment	Before treatment	After treatment
Control	9.32±1.85	8.75±1.24	12.48±3.26	10.75±1.86	10.36±1.18	8.64±1.36
Treatment	9.30±1.76	6.72±1.36	12.30±2.36	6.58±1.58	10.24±1.25	6.50±1.52
t	0.049	6.976	0.283	3.216	0.182	12.02
P	0.960	0.000	0.7140	0.000	0.857	0.000

Item	TC (mmol/L)		TG (mmol/L)		LDL-C (mmol/L)		HDL-C (mmol/L)		IMT (cm)
Item	Before Treatment	After treatment	Before treatment	After treatment	Before treatment	After treatment	Before treatment	After treatment	Before treatment	After treatment
Control	2.85±0.82	2.59±0.55^b	2.92±0.82	2.58±0.53^b	4.26±0.85	3.61±0.58^b	1.24±0.64	1.32±0.21^b	1.32±0.21	1.18±0.27^b
Treatment	2.82±0.51	2.02±0.36^b	2.89±0.45	2.04±0.16^b	4.28±0.76	2.32±0.42^b	1.23±0.54	1.86±0.52^b	1.30±0.28	0.86±0.24^b
t	0.196	5.486	0.203	6.400	0.111	11.395	0.076	5.217	0.361	5.604
P	0.844	0.000	0.840	0.000	0.912	0.000	0.940	0.000	0.720	0.000

利拉鲁肽联合二甲双胍对超重/肥胖型2型糖尿病患者糖脂代谢水平和颈动脉内膜中层厚度的影响

Liraglutide combined with metformin on glycolipid metabolism level and intima-media thickness in overweight/obese patients with type 2 diabetes mellitus

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Item	BMI (kg/m²)		Waist (cm)		Hipline (cm)
Item	Before Treatment	After treatment	Before Treatment	After treatment	Before Treatment	After treatment
Control	28.35±2.32	26.58±1.62^b	95.38±7.28	90.62±8.62^b	101.38±6.28	99.85±8.36^b
Treatment	28.02±3.24	24.14±1.52^b	95.26±6.32	86.72±6.72^b	102.04±4.26	96.36±5.36^b
t	0.524	6.947	0.079	2.257	0.551	2.223
P	0.500	0.000	0.900	0.025	0.500	0.003

Item	Treatment impact score		Physiological function score		Social relations scoring		Psychological scoring
Item	Before treatment	After treatment	Before treatment	After treatment	Before treatment	After treatment	Before treatment	After treatment
Control	9.60±1.63	6.16±0.14^b	26.70±4.10	22.12±7.37^b	14.20±3.03	7.64±1.60^b	21.60±4.01	15.48±3.20^b
Treatment	10.04±1.59	4.68±0.95^b	26.48±4.50	15.30±4.90^b	14.60±3.97	6.24±1.48^b	21.96±4.95	13.00±3.12^b
t	1.222	7.551	0.229	4.871	0.468	4.057	0.357	3.508
P	0.226	0.000	0.82	0.000	0.677	0.000	0.722	0.000

Item	Nausea	Dizzy	Vomit	Diarrhea	Total
Control	2(2.86%)	2(2.86%)	1(1.43%)	1(1.43%)	6(8.58%)
Treatment	2(2.86%)	1(1.43%）	1(1.43%)	0（0）	4(5.72%)

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