达格列净和利格列汀治疗超重或肥胖2型糖尿病伴微量白蛋白尿患者的效果比较

Effect comparision of Dapagliflozin and Linagliptin in the treatment of overweight or obese patients with type 2 diabetes and microalbuminuria

目的比较达格列净和利格列汀用于治疗超重或肥胖2型糖尿病(T2DM)伴微量白蛋白尿患者的临床效果。方法选取2019年4月—2020年4月在广东省佛山市南海区第七人民医院诊断为超重或肥胖T2DM伴微量白蛋白尿的58例患者作为研究对象,按照随机数字表法将其分为达格列净组和利格列汀组,每组各29例。两组患者均使用二甲双胍进行基础治疗。比较两组患者的血糖相关指标、胰岛素抵抗指数、肾功能相关指标及不良反应。结果治疗后,两组患者的空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(GHb)均低于治疗前,且达格列净组患者的FPG、2 h PG、GHb均低于利格列汀组,差异有统计学意义(P<0.05)。治疗后,两组患者的胰岛素抵抗指数低于治疗前,且达格列净组患者的胰岛素抵抗指数低于利格列汀组,差异有统计学意义(P<0.05)。治疗后,两组患者的尿微量白蛋白(UAlb)、尿白蛋白/肌酐比值(UACR)、血清肌酐浓度(SCr)均低于治疗前,且达格列净组患者的UAlb、UACR、SCr均低于利格列汀组,差异有统计学意义(P<0.05)。两组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论达格列净可有效改善超重或肥胖T2DM伴微白蛋白尿患者的血糖,降低胰岛素抵抗指数,改善肾功能,降低不良反应发生率。

Objective To compare the clinical efficacy of Dapagliflozin and Linagliptin in the treatment of overweight or obese patients with type 2 diabetes mellitus(T2DM)with microalbuminuria.Methods A total of 58 patients diagnosed as overweight or obese with T2DM with microalbuminuria at the Seventh People′s Hospital of Nanhai District,Foshan City,Guangdong Province from April 2019 to April 2020.According to the random number table,they were divided into Dapagliflozin group and Linagliptin group,with 29 cases in each group.Both groups were treated with Metformin for basic treatment.Blood glucose related indexes,insulin resistance index,renal function related indexes and adverse reactions were compared between the two groups.Results The fasting blood glucose(FPG),2 h postprandial glucose(2 h PG)and glycosylated hemoglobin(GHb)after treatment in the two groups were lower than those before treatment,the FPG,2 h PG and GHb in the Dapagliflozin group after treatment were lower than those in the Linagliptin group,and the differences were statistically significant(P<0.05).After treatment,the insulin resistance index of the two groups was lower than that before treatment,and the insulin resistance index of the Dapagiflozin group was lower than that of the Linaliptin group,and the differences were statistically significant(P<0.05).Urinary microalbumin(UAlb),urine albumin/creatinine ratio(UACR),and serum creatinine(SCr)after treatment in the two groups were lower than those before treatment,the UAlb,UACR and SCr of the Dapagliflozin group after treatment were lower than those of the Linagliptin group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Dapagliflozin can effectively improve the blood sugar of overweight or obese patients with T2DM with microalbuminuria,lower their insulin resistance index and improve their renal function,and reduce the incidence of adverse reactions.