二甲双胍联合达格列净治疗2型糖尿病的疗效及对微炎症状态的影响

Effect of metformin combined with dapagliflozin in the treatment of type 2 diabetes mellitus and its influence on the micro-inflammatory state

目的探讨二甲双胍联合达格列净治疗2型糖尿病(T2DM)的疗效及对机体微炎症状态的影响。方法选取T2DM患者80例,按随机数字表法均分为观察组与对照组。对照组用二甲双胍治疗,观察组用二甲双胍联合达格列净治疗,疗程为12周。对比2组不良反应或并发症发生情况,检测并比较2组治疗前后糖脂代谢指标[空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、稳态模型胰岛素抵抗指数(HOMA-IR)]、体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、肾功能相关指标[胱抑素C(CysC)、尿微量白蛋白/尿肌酐比值(ACR)]及炎症指标[C反应蛋白(CRP)和同型半胱氨酸(Hcy)]。结果治疗后,观察组的FBG达标时间明显短于对照组,HbA1c达标率高于对照组(P<0.05)。观察组的FBG、2 h PG、HbA1c、HOMA-IR、BMI、SBP、三酰甘油(TG)、CRP、Hcy、CysC和ACR均低于对照组(P<0.05);2组SBP、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)比较差异无统计学意义。2组不良反应率比较,差异无统计学意义。结论二甲双胍联合达格列净治疗T2DM能够提高血糖控制效果,减轻胰岛素抵抗及机体微炎症状态,对体质量控制更具优势且未增加低血糖事件发生风险。

Objective To investigate the effect of metformin combined with dapagliflozin in the treatment of type 2 diabetes mellitus(T2DM)and its influence on the micro-inflammatory state.Methods 80 T2DM patients were randomly and evenly divided into observation group and control group.The control group were treated with metformin,and the observation group were treated with metformin combined uith dapagliflozin for 12 weeks.The occurrence of adverse reactions or complications between the 2 groups was compared,the glucose and lipid metabolism indexes[fasting blood glucose(FBG),2 hours postprandial blood glucose(2 h PG),glycosylated hemoglobin(HbA1c),homeostasis model-insulin resistance index(HOMA-IR)],body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),renal function related indicators[cystatin-C(CysC),urine microalbumin/urinary creatinine ratio(ACR)],inflammation indicators[C-reactive protein(CRP)and homocysteine(Hcy)]were detected and compared before and after treatment between the 2 groups.Results The compliance time of FBG in observation group was significantly shorter than that in control group,and the HbA1c compliance rate was higher than that of the control group(P<0.05).After treatment,the FBG,2 h PG,HbA1c,HOMA-IR,BMI,SBP,triacylglycerol(TG),CRP,Hcy,CysC and ACR of the observation group were lower than those of the control group(P<0.05),but there was no significant difference in SBP,total cholesterol(TC),low density lipoproteinc(LDL-C)and high density lipoproteinc(HDL-C)between the 2 groups.There was no statistically significant difference in the adverse reaction rate between the 2 groups.Conclusion Metformin combined with dapagliflozin is effective for the treatment of patients with T2DM,which can improve the effect of blood glucose control,reduce the insulin resistance and micro-inflammatory state of the body,and be better for weight control with a low risk of hypoglycemic events.