钠—葡萄糖协同转运蛋白-2抑制剂对2型糖尿病患者内脏脂肪面积的作用

Effect of Sodium-Glucose Cotransporter-2 Inhibitor on Visceral Fat Area in Patients with Type 2 Diabetes

目的:观察钠—葡萄糖协同转运蛋白-2抑制剂(Sodium-glucose cotransporter 2 inhibitor SGLT2i)对2型糖尿病患者内脏脂肪面积(VFA)的作用。方法:选取2018年9月—2019年3月于黑龙江省医院住院的2型糖尿病患者78例作为研究对象,原治疗方案基础上,给予SGLT2i治疗12周,分别测量VFA、皮下脂肪面积(SFA)、体重、身高、BMI、腰围、臀围、腰臀比(WHR)第0周、4周、8周、12周值。空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、血脂、肝肾功等生化指标分别测量第0周及12周值。欧姆龙DHS-2000检测比较内脏脂肪面积前后变化,配对t检验分析SGLT2i与VFA治疗前后相关性,采用Pearson相关系数检验各变量之间的相关性。结果:62例患者完成回访,第12周与第0周相比,患者VFA减少22.19%,SFA减少4%,体重减少4%,BMI减少3%,腰围减少3.6%,均具统计学意义(P<0.05)。并且VFA与SFA、体重、BMI具有中度正相关性,与腰围有弱正相关性。FPG、2hPG、HbA1c、总胆固醇(TC)、甘油三酯(TG)、尿酸(UA)、尿素氮(UREA)较前降低(P<0.05)。高密度脂蛋白(HDL-C)较前升高(P<0.05),低密度脂蛋白(LDL-C)较前升高,差异无统计学意义(P>0.05)。出现3例泌尿系感染,停药经抗感染治疗后症状缓解。过敏1例,停药予抗过敏治疗后症状缓解。未出现低血糖、低血压、酮症酸中毒病例。结论:SGLT2i不仅降低内脏脂肪面积及皮下脂肪面积,还可以减低血糖,降低血红蛋白,减轻体重。

Objective:To observe the effect of sodium-glucose cotransporter 2 inhibitor(SGLT2i)on visceral fat area(VFA)in patients with type 2 diabetes mellitus.Methods:A total of 78 patients with type 2 diabetes mellitus admitted to Heilongjiang Provincial Hospital from September 2018 to March 2019 were enrolled.The original treatment plan was based on SGLT2i treatment for 12 weeks.The VFA,subcutaneous fat area(SFA),body weight,height,BMI,waist circumference,hip circumference,waist-to-hip ratio(WHR),0th week,4th week,8th week,12th week value.Fasting blood glucose(FPG),postprandial 2-hour blood glucose(2hPG),glycosylated hemoglobin(HbA1c),blood lipids,liver and kidney function and other biochemical indicators were measured at 0th and 12th week.Omron DHS-2000 was used to compare the changes of visceral fat area before and after.Paired t-test was used to analyze the correlation between SGLT2i and VFA before and after treatment.Pearson correlation coefficient was used to test the correlation between variables.Results:62 patients completed the return visit.12th week compared with 0th week,the patient’s VFA decreased by 22.19%;SFA decreased by 4%;weight loss decreased by 4%;BMI decreased by 3%,and waist circumference decreased by 3.6%,which was statistically significant(P<0.05).And VFA has a moderate correlation with SFA,body weight,BMI,and low correlation with waist circumference.FPG,2hPG,HbA1c,total cholesterol(TC),triglyceride(TG),uric acid(UA),and urea nitrogen(UREA)were lower than before(P<0.05).High-density lipoprotein(HDL-C)was higher than before(P<0.05),and low-density lipoprotein(LDL-C)was not significantly higher than before.There were 3 cases of urinary tract infection,and the symptoms were relieved after anti-infective treatment.1 case of allergies,the symptoms were relieved after stopping the anti-allergy treatment.There were no cases of hypoglycemia,hypotension,or ketoacidosis.Conclusion:SGLT2i not only reduces visceral fat area and subcutaneous fat area,but also reduces blood sugar,lowers hemoglobin and reduces body weight.