达格列净联合二甲双胍对2型糖尿病合并肥胖症患者糖脂代谢、胰岛功能及炎症指标的影响OA
Effects of Dapagliflozin Combined with Metformin on Glucose and Lipid Metabolism,Islet Function,and Inflammatory Markers in Patients with Type 2 Diabetes Mellitus and Obesity
目的:探讨达格列净(Dap)联合二甲双胍(Met)对 2 型糖尿病(T2DM)合并肥胖症患者糖脂代谢、胰岛功能以及炎症指标的影响.方法:前瞻性选取2021年 6 月～2024年7月本院收治的102 例 T2DM 合并肥胖症患者作为研究对象,采用随机数字表法分为对照组和观察组,每组 51例.两组患者均根据自身症状接受基础非药物治疗,对照组在此基础上给予盐酸二甲双胍片治疗,观察组在对照组基础上联合达格列净片治疗,两组均持续治疗 3 个月.比较两组糖脂代谢标志物[空腹血糖(FPG)、餐后 2 h 血糖(2hPG)、脂蛋白相关磷脂酶A2(Lp-PLA2)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)]、胰岛功能相关标志物[胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)]、炎症指标[血小板计数与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)]、临床疗效及治疗安全性.结果:治疗 3 个月后,两组 FPG、2hPG、Lp-PLA2、HbA1c、TC、TG、LDL-C、HOMA-IR、PLR和NLR均降低,且观察组低于对照组(P＜0.05);HDL-C 和 HOMA-β 均升高,且观察组高于对照组(P＜0.05).观察组临床治疗总有效率(96.08%)高于对照组(80.39%,P＜0.05).两组不良反应总发生率比较无统计学差异(P＞0.05).结论:Dap 联合 Met 治疗 T2DM 合并肥胖症患者效果确切,可有效调控机体糖脂代谢,改善胰岛素抵抗,下调炎症指标NLR及PLR,改善胰岛功能,且未增加不良反应发生风险.
Objective:To investigate the effects of dapagliflozin(Dap)combined with metformin(Met)on glucose and lipid metabolism,islet function,and inflammatory markers in patients with type 2 diabetes mellitus(T2DM)and obesity.Methods:A total of 102 patients with T2DM and obesity admitted to our hospital from June 2021 to July 2024 were prospectively enrolled and randomly assigned,using a random number table method,to a control group and an observation group,with 51 patients in each group.Both groups received basic non-drug treatment according to their symptoms.On this basis,the control group received metformin hydrochloride tablets,while the observation group received dapagliflozin tablets in addition to the control treatment.Both groups were treated for 3 months.Glucose and lipid metabolism markers[fasting plasma glucose(FPG),2-hour postprandial plasma glucose(2hPG),lipoprotein-associated phospholipase A2(Lp-PLA2),glycosylated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)],islet function-related markers[homeostasis model assessment of insulin resistance(HOMA-IR)and homeostasis model assessment of β-cell function(HOMA-β)],inflammatory markers[platelet-to-lymphocyte ratio(PLR)and neutrophil-to-lymphocyte ratio(NLR)],clinical efficacy,and treatment safety were compared between the two groups.Results:After 3 months of treatment,FPG,2hPG,Lp-PLA2,HbA1c,TC,TG,LDL-C,HOMA-IR,PLR,and NLR decreased in both groups and were lower in the observation group than in the control group(P<0.05).HDL-C and HOMA-β increased in both groups and were higher in the observation group than in the control group(P<0.05).The total effective rate of treatment was higher in the observation group than in the control group(96.08%vs 80.39%,P<0.05).There was no significant difference in the overall incidence of adverse reactions between the two groups(P>0.05).Conclusion:Dap combined with Met has definite efficacy in patients with T2DM and obesity.It can effectively regulate glucose and lipid metabolism,improve insulin resistance,reduce the inflammatory markers NLR and PLR,and improve islet function without increasing the risk of adverse reactions.
王莉莉;魏伟;齐小峰
郑州颐和医院内分泌科,郑州 450000郑州人民医院内分泌科,郑州 450000郑州颐和医院内分泌科,郑州 450000
医药卫生
达格列净二甲双胍2型糖尿病肥胖症胰岛素抵抗指数中性粒细胞与淋巴细胞比值血小板计数与淋巴细胞比值
dapagliflozinmetformintype 2 diabetes mellitusobesityhomeostasis model assessment of insulin resistanceneutrophil-to-lymphocyte ratioplatelet-to-lymphocyte ratio
《中国合理用药探索》 2026 (6)
75-82,8
河南省医学科技攻关计划项目(LHGJ20211097)
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