盐酸二甲双胍联合利格列汀治疗对肥胖型T2DM患者胰岛素抵抗及血清vaspin水平的影响OA
Effect of metformin hydrochloride combined with linagliptin therapy on insulin resistance and serum vaspin level in obese patients with type 2 diabetes mellitus
目的 探讨盐酸二甲双胍联合利格列汀治疗对肥胖型2型糖尿病(T2DM)患者胰岛素抵抗及血清丝氨酸蛋白酶抑制剂(vaspin)水平的影响.方法 选取2021年2月至2024年1月西安医学院附属宝鸡医院收治的122例肥胖型T2DM 患者作为研究对象,采用随机数字表法将其分为对照组和试验组.所有患者均使用盐酸二甲双胍治疗,对照组在盐酸二甲双胍治疗的基础上加用安慰剂,试验组在盐酸二甲双胍治疗的基础上加用利格列汀.比较2组不良反应发生情况及治疗前后血糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)]、体质量指数(BMI)、血脂指标[甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、胰岛细胞功能指标[空腹胰岛素(FINS)、胰岛素β细胞功能指数(HOMA-β)、稳态模型胰岛素抵抗指数(HOMA-IR)]及血清vaspin水平.结果 治疗后2组FPG、2 h PBG、HbA1c、TC、TG及LDL-C水平均低于治疗前,且试验组FPG、2 h PBG、HbA1c、TC、TG及LDL-C水平均低于对照组,差异均有统计学意义(P<0.05).治疗后2组FINS水平、HOMA-IR、BMI均低于治疗前,且试验组FINS水平、HOMA-IR、BMI均低于对照组,差异均有统计学意义(P<0.05).治疗后2组 HOMA-β及 HDL-C水平均高于治疗前,且试验组 HOMA-β及 HDL-C水平均高于对照组,差异均有统计学意义(P<0.05).治疗后2组血清vaspin水平低于治疗前,且试验组血清vaspin水平低于对照组,差异均有统计学意义(P<0.05).2组不良反应总发生率比较,差异无统计学意义(P=0.697).结论 盐酸二甲双胍联合利格列汀治疗肥胖型T2DM 患者,能降低其血糖、血脂水平,改善胰岛素抵抗,促进胰岛细胞功能恢复,降低血清vaspin水平,且安全性良好.
Objective To investigate the effects of metformin hydrochloride combined with linagliptin ther-apy on insulin resistance and serum serine protease inhibitor(vaspin)level in obese patients with type 2 diabe-tes mellitus(T2DM).Methods A total of 122 obese patients with T2DM admitted to Baoji Hospital Affilia-ted to Xi'an Medical University from February 2021 to January 2024 were enrolled as research subjects,and they were divided into a control group and an experimental group by the random number table method.All pa-tients received metformin hydrochloride treatment.On this basis,the control group was given placebo,while the experimental group was given linagliptin.The incidence of adverse reactions,blood glucose metabolism in-dexes[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2 h PBG),glycated hemoglobin A1c(HbA1c)],body mass index(BMI),blood lipid indexes[triglyceride(TG),total cholesterol(TC),high-den-sity lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],islet cell function indexes[fasting insulin(FINS),homeostasis model assessment of β-cell function(HOMA-β),homeostasis model as-sessment of insulin resistance(HOMA-IR)]and serum vaspin levels were compared between the two groups before and after treatment.Results After treatment,the levels of FPG,2 h PBG,HbA1c,TC,TG and LDL-C in the two groups were lower than those before treatment,and the levels of FPG,2 h PBG,HbA1c,TC,TG and LDL-C in the experimental group were lower than those in the control group,the differences were statisti-cally significant(P<0.05).After treatment,the FINS level,HOMA-IR and BMI of the two groups were low-er than those before treatment,and the FINS level,HOMA-IR and BMI of the experimental group were lower than those of the control group,and the differences were statistically significant(P<0.05).After treatment,the HOMA-β and HDL-C levels of the two groups were higher than those before treatment,and the HOMA-β and HDL-C levels of the experimental group were higher than those of the control group,and the differences were statistically significant(P<0.05).After treatment,the serum vaspin levels of the two groups were low-er than those before treatment,and the serum vaspin level of the experimental group was lower than that of the control group,and the differences were statistically significant(P<0.05).There was no significant differ-ence in the total incidence of adverse reactions between the two groups(P=0.697).Conclusion Metformin hydrochloride combined with linagliptin in the treatment of obese T2DM patients can reduce the blood glucose and blood lipid levels,improve insulin resistance,promote the recovery of islet cell function and reduce the ser-um vaspin level,with good safety.
廖静;刘建军;林春发
西安医学院附属宝鸡医院药剂科,陕西 宝鸡 721006神木市医院药学部,陕西神木 719300陕西省中医医院药剂科,陕西 西安 710003
医药卫生
利格列汀2型糖尿病胰岛素抵抗丝氨酸蛋白酶抑制剂肥胖症脂肪因子
linagliptintype 2 diabetes mellitusinsulin resistanceserine protease inhibitorobe-sityadipokine
《检验医学与临床》 2026 (15)
2030-2035,2042,7
陕西省重点研发计划项目(2022SF-227).
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