地舒单抗联合利拉鲁肽治疗2型糖尿病合并骨质疏松症的疗效及对骨代谢指标的影响OA

Objective To investigate the efficacy of denosumab combined with liraglutide in treating type 2 diabetes mellitus(T2DM)complicated with osteoporosis and its effect on bone metabolism indicators,so as to provide a reference for the clinical treatment of patients with T2DM complicated with osteoporosis.Methods A total of 126 patients with T2DM com-plicated with osteoporosis admitted to Kailuan General Hospital from January 2023 to July 2024 were retrospectively enrolled and assigned to a control group(n=61)and an observation group(n=65)according to the treatment regimen.Patients in the control group received conventional glucose-lowering therapy combined with denosumab,while patients in the observa-tion group received conventional glucose-lowering therapy combined with denosumab and liraglutide.Both groups were trea-ted for 12 months.The clinical efficacy,glucose metabolism indicators,bone metabolism indicators,Visual Analog Scale(VAS)scores,Hamilton Anxiety Scale(HAMA)scores,and occurrence of adverse reactions were compared between the two groups.Results The overall response rate in the observation group was significantly higher than that in the control group(81.54%[53/65]vs.55.74%[34/61];χ2=9.802,P=0.002).Before treatment,there were no statistically sig-nificant differences in fasting plasma glucose(FPG),2-hour postprandial plasma glucose(2 h PG),and glycated hemoglo-bin(HbA1c)levels between the two groups(P>0.05).After treatment,FPG,2 h PG,and HbA1c levels in both groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).Before treatment,there were no statistically significant differences in serum 25-hydroxyvitamin D[25(OH)D],β-crosslaps(β-CTX),and calcitonin(CT)levels between the two groups(P>0.05).After treatment,serum 25(OH)D and CT levels in both groups were higher than those before treatment,and the levels in the observation group were higher than those in the control group;serum β-CTX levels in both groups were lower than those before treatment,and the level in the observation group was lower than that in the control group,with statistical-ly significant differences(P<0.05).Before treatment,there were no statistically significant differences in VAS and HA-MA scores between the two groups(P>0.05).After treatment,VAS and HAMA scores in both groups were lower than those before treatment,and the scores in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The incidence of adverse reactions during the treatment period was 42.62%(26/61)in the control group and 44.61%(29/65)in the observation group,with no statistically significant difference(χ2=0.051,P=0.822).Conclusion The addition of liraglutide to conventional glucose-lowering therapy combined with denosumab can further improve the clinical efficacy in patients with T2DM complicated with osteoporosis,improve glucose metabolism,optimize bone me-tabolism indicators,and more effectively relieve bone pain and anxiety symptoms,without increasing additional safety risks.