西格列汀二甲双肌联合唑来膦酸对糖尿病合并骨质疏松患者糖脂代谢及骨代谢水平的影响研究

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【中图分类号】 R977.1+5 【文献标识码】A

【Abstract】 Objective To explore the effect of sitagliptin and metformin combined with zoledronic acid in the treatment of type 2 diabetes mellitus （T2DM） complicated with osteoporosis （OP） on the levels of glucose and lipid metabolism and bone metabolism in patients.

Methods Patients with T2DM combined with OP admited to Nantong Second People's Hospital from January2021to January 2024 were selectedas the research subjects and randomlydivided into thecombined group （sitagliptin and metformin combined with zoledronic acid） and the control group （zoledronic acid only）. After6 months of treatment，the clinical effcacyglucoseand lipid metabolism indicators [fasting blood glucose （FBG），2-hour postprandial blood glucose （2hPG）， glycated hemoglobin （HbAlc），total cholesterol （TC），triglycerides （TG），high-density lipoprotein cholesterol （HDL-C），low-density lipoproteincholesterol （LDL-C）]， bone metabolism indicators [osteoprotegerin （OPG）， bone-specific alkaline phosphatase （BALP）， osteocalcin （OC）] levels，changes in bone density，and incidence of adverse reactions werecompared between the two groups beforeand after treatment.Results A total of 120 patients were included， with 60 patients in each group. After treatment， the total effective rate of the combination group was 93.33% ， significantly higher than the control group's 73.33% 1 （P<0.05） . The levels of FBG，2hPG，HbA1c，TC，TG，and LDL-C in two groups were significantly lower than those before treatment， while the levels of HDL-C， OPG，BALP， OC，and bone density in the femoral neck and lumbar spine were significantly higher than before treatment （P<0.05） ； and all indicators of the combined group were better than those of the control group （P<0.05） . There was no statisticall significant difference in the total incidence of adverse reactions between the two groups （P>0.05） ： Conclusion Sitagliptin and metformin combined with zoledronic acid in the treatment of patients with T2DM complicated with OP is more effective in regulating their glycolipid metabolism and bone metabolism levels，increasing bone density， improving therapeutic effects，and it has beter safety than zoledronic acid alone.

【Keywords】Type 2 diabetes melitus; Osteoporosis; Sitagliptin and metformin; Zoledronic acid： Glucose and lipid metabolism; Bone metabolism

2型糖尿病（type2diabetesmellitus，T2DM）是一种多发的慢性代谢性疾病，其在所有糖尿病人群中占比 90% 以上，以胰岛素抵抗和胰岛β细胞功能逐渐下降为主要特征，危害性较大[]。（剩余12361字）