格列美脲联合沙格列汀对腹型肥胖糖尿病患者脂代谢指标及胰岛功能的影响

Effect of Glimepiride Combined with Saxagliptin on Lipid Metabolism Indexes and Islet Function in Patients with Abdominal Obesity Diabetes Mellitus

目的研究格列美脲联合沙格列汀对腹型肥胖糖尿病患者脂代谢指标及胰岛功能的影响。方法选取2020年7月-2021年5月天津市第二医院内分泌科收治的84例腹型肥胖糖尿病患者,按照随机数字表法分为对照组与观察组,各42例。对照组给予格列美脲治疗,观察组给予格列美脲联合沙格列汀治疗,比较两组血糖水平[空腹血糖(FBG)、餐后2h血糖(PBG)、糖化血红蛋白(HbA1c)]、脂代谢指标[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]、胰岛功能[空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)]、BMI及腰臀比。结果两组治疗后FBG、PBG、HbA1c水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组治疗后TG、TC、LDL-C水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组治疗后FINS、HOMA-β高于治疗前,HOMA-IR低于治疗前,且观察组FINS、HOMA-β高于对照组,HOMA-IR低于对照组,差异有统计学意义(P<0.05);两组治疗后BMI、腰臀比低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论格列美脲联合沙格列汀对腹型肥胖糖尿病患者的降糖效果确切,可调节脂代谢指标,改善胰岛功能,促进患者体重指数及腰臀比的下降。

Objective To study the effect of glimepiride combined with saxagliptin on lipid metabolism indexes and islet function in patients with abdominal obesity diabetes mellitus.Methods A total of 84 patients with abdominal obesity diabetes mellitus admitted to the Department of Endocrinology of Tianjin Second Hospital from July 2020 to May 2021 were selected and randomly divided into control group and observation group,with 42 cases in each group.The control group was treated with glimepiride,and the observation group was treated with glimepiride combined with saxagliptin.The blood glucose levels[fasting blood glucose(FBG),postprandial 2 h blood glucose(PBG),glycosylated hemoglobin(HbA1c)],lipid metabolism indexes[triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)],islet function[fasting insulin(FINS),insulin resistance index(HOMA-IR),insulin secretion index(HOMA-β)],BMI and waist hip ratio were compared between the two groups.Results After treatment,the levels of FBG,PBG and HbA1c in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05);the levels of TG,TC and LDL-C in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05);FINS and HOMA-β in the two groups were higher than those before treatment,HOMA-IR was lower than that before treatment,FINS and HOMA-β in the observation group were higher than those in the control group,HOMA-IR was lower than that in the control group,the difference was statistically significant(P<0.05);BMI and waist-hip ratio in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).Conclusion Glimepiride combined with saxagliptin has definite hypoglycemic effect on patients with abdominal obesity and diabetes,which can regulate lipid metabolism indexes,improve islet function,and promote the decrease of body mass index and waist-hip ratio.