二甲双胍联合格列美脲或卡格列净对老年糖尿病患者胰岛功能、血清FFA、Asprosin水平的影响

Effect of Metformin combined with Glimepiride or Canagliflozin on pancreatic islet function,serum FFA,Asprosin levels in elderly patients with diabetes

目的探讨二甲双胍联合格列美脲或卡格列净对老年糖尿病患者胰岛功能、血清游离脂肪酸(FFA)、白脂素(Asprosin)水平的影响。方法选取2018年6月~2020年6月佛山市第二人民医院健康管理中心收治的108例老年糖尿病患者作为研究对象,采用随机数字表法分为对照组(n=54)和观察组(n=54)。对照组给予二甲双胍治疗,观察组给予二甲双胍联合格列美脲或卡格列净治疗,比较两组血糖[空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)]、胰岛功能指标[胰岛β细胞功能(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]、血清FFA和Asprosin水平、脂代谢指标[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)]、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]、及不良反应总发生率。结果治疗后,观察组FPG、2 h PBG、HbA1c、TC、TG、LDL-C、HOMA-IR、FFA、Asprosin、MDA、SOD水平低于对照组,HDL-C、HOMA-β水平高于对照组,差异有统计学意义(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论二甲双胍联合格列美脲或卡格列净可控制老年糖尿病患者血糖,改善胰岛功能和脂代谢,降低血清FFA、Asprosin水平。

Objective To explore the effect of Metformin combined with Glimepiride or Canagliflozin on pancreatic islet function,serum free fatty acids(FFA),Asprosin levels in elderly patients with diabetes.Methods A total of 108 elderly diabetic patients admitted to the Health Management Center,the Second People′s Hospital of Foshan from June 2018 to June 2020 were selected as the research objects and divided into the control group(54 cases)and the observation group(54 cases)according to the random number table method.The control group was treated with Metformin,while the observation group was treated with Metformin combined with Glimepiride or Canagliflozin.Blood glucose(fasting plasma glucose[FPG],2 h postprandial blood glucose[2 h PBG],glycosylated hemoglobin[HbA1c]),pancreatic islet function indicators(homeostatic model assessment ofβ-cell function[HOMA-β],homeostasis model assessment of insulin resistance[HOMA-IR]),serum FFA and Asprosin levels,lipid metabolism indicators(total cholesterol[TC],triglycerides[TG],low-density lipoprotein cholesterol[LDL-C],high-density lipoprotein cholesterol[HDL-C]),oxidative stress indicators(malondialdehyde[MDA],superoxide dismutase[SOD]),and the total incidence of adverse reactions were compared between the two groups.Results After treatment,the levels of FPG,2 h PBG,HbA1c,TC,TG,LDL-C,HOMA-IR,FFA,Asprosin,MDA,and SOD of the observation group were lower than those of the control group,while the levels of HDL-βand HOMA-IR of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidences of adverse reactions between the two groups(P>0.05).Conclusion Metformin combined with Glimepiride or Canagliflozin could control blood glucose,improve pancreatic islet function and lipid metabolism,and lower serum FFA and Asprosin levels in elderly diabetic patients.