利拉鲁肽联合达格列净对超重或肥胖2型糖尿病患者肾功能、氧化应激以及内脏脂肪含量的影响

Effects of Liraglutide Combined with Dapagliflozin on Renal Function,Oxidative Stress and Visceral Fat Content in Overweight or Obese Patients with Type 2 Diabetes Mellitus

目的:探讨利拉鲁肽联合达格列净对超重或肥胖2型糖尿病(T2DM)患者肾功能、氧化应激以及内脏脂肪含量的影响。方法:选取我院于2018年1月2020年5月期间接收的108例超重或肥胖T2DM患者,按照随机数字表法分为对照组(n=54)和观察组(n=54)。对照组给予利拉鲁肽治疗,观察组给予利拉鲁肽联合达格列净治疗,均治疗12周。对比两组肾功能[血胱抑素C(CysC)、血肌酐(Scr)、血尿酸(SUA)]、氧化应激[丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-PX)、超氧化物歧化酶(SOD)]、体质量指数(BMI)、腰围、血糖指标[空腹血糖(FBG)、餐后2 h血糖(2hPBG)、糖化血红蛋白(HbA1c)]以及体成分指标(全身脂肪百分比、内脏脂肪含量),记录两组治疗期间不良反应情况。结果:两组治疗后BMI、腰围、2hPBG、FBG、HbA1c均下降,且观察组较对照组低(P<0.05)。两组治疗后MDA均下降,且观察组较对照组低(P<0.05),两组治疗后SOD、GSH-PX均升高,且观察组较对照组高(P<0.05)。两组治疗后全身脂肪百分比、内脏脂肪含量均下降,且观察组较对照组低(P<0.05)。两组治疗前后CysC、Scr、SUA组内及组间对比均无统计学差异(P>0.05)。两组不良反应发生率对比无统计学差异(P>0.05)。结论:超重或肥胖T2DM患者利拉鲁肽治疗基础上联合达格列净,降糖效果确切,减轻机体氧化应激,降低内脏脂肪含量,对肾功能无显著影响,且不增加不良反应发生率。

Objective:To investigate the effects of liraglutide combined with dapagliflozin on renal function,oxidative stress and visceral fat content in overweight or obese patients with type 2 diabetes mellitus(T2DM).Methods:108 overweight or obese patients with T2DM who came to our hospital from January 2018 to May 2020 were selected,they were randomly divided into control group(n=54)and observation group(n=54).The control group was treated with liraglutide,and the observation group was treated with liraglutide combined with dapagliflozin,all were treated for 12 weeks.The renal function[serum cystatin C(CysC),serum creatinine(Scr),blood uric acid(SUA)],oxidative stress[malondialdehyde(MDA),glutathione peroxidase(GSH-PX),superoxide dismutase(SOD)],body mass index(BMI),waist circumference,blood glucose indexes[fasting blood glucose(FBG),2 h postprandial blood glucose(2hPBG),glycosylated hemoglobin(HbA1c)]and body composition index(body fat percentage,visceral fat content)in the two groups were compared.Adverse reactions during treatment in the two groups were recorded.Results:BMI,waist circumference,2hPBG,FBG and HbA1c in the two groups after treatment decreased,and the observation group was lower than the control group(P<0.05).MDA in the two groups after treatment decreased,and the observation group was lower than the control group(P<0.05).SOD and GSH-PX increased in both groups after treatment,and the observation group were higher than the control group(P<0.05).After treatment,the percentage of body fat and visceral fat in the two groups decreased,and the observation group was lower than the control group(P<0.05).There were no differences in CysC,Scr and SUA within and between the two groups before and after treatment(P>0.05).There was no difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion:Liraglutide combined with dapagliflozin in the treatment of overweight or obese patients with T2DM can effectively reduce blood glucose,reduce body’s oxidative stress,reduce visceral fat content,and have no significant effect on renal function,and do not increase the incidence of adverse reactions.