达格列净对中心肥胖型新诊断T2MD患者β胰岛细胞功能和脂代谢紊乱的影响

Effects of dapagliflozin on β islet cell function and lipid metabolism disorder in newly diagnosed T2MD patients with central obesity

目的探讨达格列净对中心肥胖型新诊断2型糖尿病(T2MD)患者β胰岛细胞功能和脂代谢紊乱的影响。方法采用计算机随机数字法将2017年8月至2018年3月该院收治的中心肥胖型T2DM患者106例分为对照组和观察组,每组53例。两组患者均予以饮食控制和运动治疗,对照组在此基础上予以二甲双胍治疗,观察组予以二甲双胍联合达格列净治疗。观察两组患者治疗前后体质量指数(BMI)、腰围、糖代谢[空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)]、脂代谢[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、胰岛β细胞功能[胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]等指标变化情况。结果两组患者治疗24周后BMI、腰围、HOMA-IR,以及血清FPG、2hPG、HbA1c、TC、TG、LDL-C水平均较治疗前明显降低,且观察组明显低于对照组,血清HDL-C水平、HOMA-β则较治疗前明显升高,且观察组明显高于对照组,差异均有统计学意义(P<0.05)。结论达格列净治疗中心肥胖型T2DM疗效好,可明显减轻体质量、缩小腰围,降低血糖和血脂水平,并促进胰岛β细胞功能的恢复。

Objective To explore the effects of dapagliflozin on β islet cell function and lipid metabolism disorder in newly diagnosed type 2 diabetes mellitus (T2MD) patients with central obesity.Methods A total of 106 T2DM patients with central obesity,who were received in the hospital from August 2017 to March 2018,were divided into control group and observation group according to the computer random number method,53 cases in each group.Both groups were given dietary control and exercise therapy,and the control group was added with metformin on this basis,and the observation group was added with metformin combined with dapagliflozin.The BMI index,waist circumference,glucose metabolism [fasting plasma glucose (FPG),postprandial 2h blood glucose (2hPG),glycosylated hemoglobin (HbA1c)],lipid metabolism [total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C)] and islet β cell function [index of β-cell function in HOMA (HOMA-β) and homeostasis model assessment of insulin resistance (HOMA-IR)] were observed in both groups before and after treatment.Results After 24 weeks of treatment,the BMI index,waist circumference,HOMA-IR,serum levels of FPG,2hPG,HbA1c,TC,TG and LDL-C in the two groups were lower than those before treatment,and the above indexes in the observation group were lower than those in the control group (P<0.05),and serum HDL-C level and HOMA-β were higher than those before treatment,and the both indexes in the observation group were higher than those in the control group,the difference had statistical significance (P<0.05).Conclusion Dapagliflozin has good efficacy in the treatment of T2DM patients with central obesity,and it can significantly reduce body weight,narrow waist circumference,lower levels of blood glucose and blood lipids,and promote recovery of islet β cell function.