达格列净联合二甲双胍对超重T2DM患者内脏脂肪面积与糖脂代谢调控作用的研究

Dapagliflozin combined with Metformin in regulation of visceral fat area and glucose-lipid metabolism in overweight type 2 diabetes mellitus patients

摘要:

目的 探讨达格列净联合二甲双胍对超重2型糖尿病（T2DM）患者内脏脂肪面积及糖脂代谢的调控作用。方法 选取2023年3月—2023年12月昌吉回族自治州人民医院收治的100例超重T2DM患者，采用随机数字表法分为对照组（二甲双胍治疗）和实验组（达格列净联合二甲双胍治疗），各50例。比较两组患者治疗前后的体型特征指标、血压、糖代谢指标、血脂指标、内脏脂肪面积。结果 实验组治疗前后体质量指数（BMI）、腰围、臀围、腰臀比的差值均大于对照组（P <0.05）。实验组治疗前后舒张压、收缩压的差值均高于对照组（P <0.05）。实验组治疗前后空腹血糖（FPG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）、糖化血红蛋白（HbA1c）的差值均高于对照组（P <0.05）。实验组治疗前后总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）的差值均高于对照组（P <0.05）。实验组治疗前后内脏脂肪面积的差值大于对照组（P <0.05）。结论 达格列净联合二甲双胍治疗对超重T2DM患者具有多重代谢获益，包括降低内脏脂肪面积、改善糖脂代谢紊乱及降低血压，这种综合效应得益于两种药物的协同作用机制。

Abstract:

Objective To investigate the effects of dapagliflozin combined with metformin on visceral fat area (VFA) and glucose-lipid metabolism in overweight type 2 diabetes mellitus (T2DM) patients.Methods A total of 100 overweight T2DM patients admitted to Xinjiang Changji Prefecture People's Hospital from March 2023 to December 2023 were selected and randomly divided into a control group (n = 50, metformin treatment) and an experimental group (n = 50, dapagliflozin added to metformin). Body characteristic indicators, blood pressure parameters, glucose metabolism indicators, lipid profiles, and VFA were compared between the two groups.Results The experimental group showed greater reductions in body mass index, waist circumference, hip circumference, and waist-to-hip ratio compared with the control group (P < 0.05). Differences in diastolic and systolic blood pressure were also greater in the experimental group (P < 0.05). Improvements in fasting plasma glucose, fasting insulin, homeostasis model assessment of insulin resistance, and glycated hemoglobin were more pronounced in the experimental group than in the control group (P < 0.05). The experimental group exhibited more favorable changes in total cholesterol, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol (P < 0.05). Reduction in VFA was greater in the experimental group compared with the control group (P < 0.05).Conclusion The combination of dapagliflozin and metformin effectively reduces visceral fat accumulation and improves glycolipid metabolism in overweight T2DM patients, these comprehensive effects are attributed to the synergistic mechanisms of the two drugs.