二甲双胍联合达格列净治疗对超重及肥胖T2DM患者血糖水平、血脂代谢及体脂含量的影响

Effects of metformin combined with dapagliflozin on blood glucose levels,blood lipid metabolism and body fat content in overweight and obese T2DM patients

目的探讨二甲双胍联合达格列净治疗对超重及肥胖2型糖尿病(T2DM)患者血糖水平、血脂代谢及体脂含量的影响。方法选取2018年9月至2020年9月在我科诊治的超重及肥胖T2DM患者107例为研究对象,采用随机数字法分为两组,对照组患者给予二甲双胍治疗,观察组患者给予二甲双胍联合达格列净治疗,疗程6个月。比较两组患者治疗前后的血糖水平、血脂水平、体脂含量的变化情况。结果治疗前,两组患者的血糖水平比较,差异无统计学意义(P>0.05);治疗6个月后,两组患者的糖化血红蛋白(HbA1c)、空腹血糖(FPG)和餐后2h血糖(2hPG)水平均显著降低,观察组患者的水平显著低于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的血脂水平比较,差异无统计学意义(P>0.05)。治疗6个月后,两组患者的胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平均显著降低,观察组患者的水平显著低于对照组;两组患者的高密度脂蛋白胆固醇(HDL-C)均显著升高,观察组患者的水平显著高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的体脂含量比较,差异无统计学意义(P>0.05);治疗6个月后,观察组患者的全身皮下脂肪率、内脏脂肪含量和体脂肪率均显著低于对照组,全身肌肉率显著高于对照组,差异有统计学意义(P<0.05)。结论二甲双胍联合达格列净治疗可明显降低超重及肥胖T2DM患者的血糖水平,改善患者的血脂代谢状况,降低患者的体脂含量。

Objective To investigate the effects of metformin combined with dapagliflozin on blood glucose levels,blood lipid metabolism and body fat content in overweight and obese patients with type 2 diabetes mellitus(T2DM).Methods A total of 107 overweight and obese T2DM patients who were diagnosed and treated in our department from September 2018 to September 2020 were selected as the research objects,which were divided into two groups by the random number method.The control group was treated with metformin,whereas the observation group was given metformin combined with dapagliflozin treatment,for a six-month treatment course.The changes of blood glucose levels,blood lipid levels and body fat content were compared between the two groups before and after treatment.Results Before treatment,there were no statistically significant differences in blood glucose levels between the two groups(P>0.05).After 6 months of treatment,the levels of glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG)and 2 hours postprandial blood glucose(2hPG)of patients in both groups decreased significantly.And the levels mentioned above in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).Before treatment,there were no statistically significant differences in blood lipid levels between the two groups(P>0.05).After 6 months of treatment,the levels of total cholesterol(TC),triacylglycerol(TG)and low-density lipoprotein cholesterol(LDL-C)significantly decreased in the two groups,and the levels in the observation group were significantly lower than those in the control group.The levels of high-density lipoprotein cholesterol(HDL-C)in the two groups increased significantly,and the level of the observation group was significantly higher than that of the control group,with a statistically significant difference(P<0.05).Before treatment,there was no statistically significant difference in body fat content between the two groups(P>0.05).After 6 months of treatment,the observation group yielded lower levels of the whole-body subcutaneous fat rate,visceral fat content and body fat percentage,whereas higher level of the whole-body muscle rate as compared with the control group,with statistically significant differences(P<0.05).Conclusion Metformin combined with dapagliflozin can significantly decrease blood glucose levels,improve the condition of blood lipid metabolism and reduce the body fat content in overweight and obese T2DM patients.