二甲双胍联合利格列汀治疗新诊断2型糖尿病的疗效及其对体脂分布的影响

Efficacy of metformin combined with ligliptin in the treatment of newly diagnosed type 2 diabetes mellitus and its effect on body fat distribution

目的探讨二甲双胍联合利格列汀治疗新诊断2型糖尿病(T2DM)的疗效及其对体脂分布的影响。方法将2017年6月至2018年10月韶关市第一人民医院收治的76例新诊断T2DM患者根据随机数表法分为二甲双胍治疗组25例(A组)、利格列汀治疗组25例(B组)以及二甲双胍+利格列汀联合治疗组26例(C组)。所有患者均治疗12周,比较三组患者治疗前后的血糖指标[空腹血糖(FPG)、糖负荷后2 h血糖(2 hPG)、空腹胰岛素(FINS)、糖负荷后2 h胰岛素(PINS)、糖化血红蛋白(HbA1c)]、体脂指标[BMI、腰臀比(WHR)、体内脂肪百分比]的差异。结果 C组患者治疗后的FPG、2 hPG、HbA1c分别为(7.68±2.01) mmol/L、(12.03±1.95) mmol/L、(7.89±1.88)%,明显低于B组的(6.01±1.89) mmol/L、(10.03±1.57) mmol/L、(5.02±1.68)%和A组的(4.72±1.08) mmol/L、(8.25±1.01) mmol/L、(5.02±1.68)%,差异均有统计学意义(P<0.05);C组患者治疗后的FINS、PINS分别为(6.32±1.25) MU/L和(26.21±6.98) MU/L,明显高于B组的(7.89±1.38) MU/L、(35.20±7.58) MU/L和A组的(9.02±2.35) MU/L、(42.35±9.65) MU/L,差异均有统计学意义(P<0.05);C组患者治疗后的BMI、WHR、体内脂肪百分比分别为24.01±3.02、0.90±0.31、(22.01±2.65)%,明显低于B组的23.85±2.69、0.85±0.29、(23.15±2.77)%和A组的22.10±2.01、0.71±0.21、(22.01±2.65)%,差异均有统计学意义(P<0.05);A、B、C三组患者的不良反应发生率分别为8.00%、4.00%、3.85%,差异无统计学意义(P>0.05)。结论二甲双胍联合利格列汀治疗新诊断2型糖尿病效果优于单独二甲双胍和利格列汀,且可明显减少体内脂肪,控制体重。

Objective To investigate the efficacy of metformin combined with ligliptin in the treatment of newly diagnosed type 2 diabetes mellitus(T2 DM) and its effect on body fat distribution. Methods A total of 76 patients with newly diagnosed T2DM admitted to Shaoguan First People’s Hospital from June 2017 to October 2018 were randomly divided into metformin treatment group(group A, 25 cases), ligliptin treatment group(group B, 25 cases) and combination of metformin & ligliptin treatment group(group C, 26 cases). All patients were treated for 12 weeks. The differences of blood glucose indexes and body fat indexes were compared between the three groups before and after treatment. The blood glucose indexes included fasting blood glucose(FPG), 2 h postload plasma glucose(2 h PG), fasting insulin(FINS), 2 h post-prandial insulin(2 h PINS), and glycated hemoglobin(HbA1c);the body fat indexes included BMI, waist-hip ratio(WHR), and body fat percentage. Results After treatment, the FPG, 2 h PG and HbA1c in group C were respectively(7.68±2.01) mmol/L,(12.03±1.95) mmol/L, and(7.89±1.88)%, which were significantly lower than corresponding(6.01±1.89) mmol/L,(10.03±1.57) mmol/L,(5.02±1.68)% in group B, and(4.72±1.08) mmol/L,(8.25±1.01) mmol/L,(5.02±1.68)% in group A;all differences were statistically significant(P<0.05). After treatment, the FINS and PINS in group C were respectively(6.32±1.25) MU/L and(26.21±6.98) MU/L, which were significantly higher than corresponding(7.89±1.38) MU/L and(35.20±7.58) MU/L in group B,(9.02±2.35) MU/L and(42.35±9.65) MU/L in group A;all differences were statistically significant(P<0.05). After treatment, the BMI, WHR and body fat percentage in group C were respectively 24.01±3.02, 0.90±0.31,(22.01±2.65)%, which were significantly lower than corresponding 23.85±2.69, 0.85±0.29,(23.15±2.77)% in group B, and 22.10±2.01, 0.71±0.21,(22.01±2.65)% in group A;all differences were statistically significant(P<0.05). The incidence of adverse reactions in group A, B and C were 8.00%, 4.00% and 3.85%, respectively(P>0.05). Conclusion The efficacy of metformin combined with ligliptin is better than that of metformin or ligliptin alone in the treatment of newly diagnosed type 2 diabetes mellitus. It also can significantly reduce the body fat and control body weight.