利拉鲁肽联合达格列净治疗肥胖2型糖尿病的疗效研究

Efficacy of Liraglutide Combined with Dapagliflozin in the Treatment of Obese Type 2 Diabetes Mellitus

目的 探究利拉鲁肽联合达格列净治疗肥胖2型糖尿病(diabetes mellitus type 2,T2DM)的可行性。方法选择2020年6月—2021年6月重庆市高新区人民医院就诊的肥胖2型糖尿病患者96例为研究对象,以1:1比例分布法将其划分为对照组与观察组,每组48例。对照组患者实施利拉鲁肽治疗,观察组患者实施利拉鲁肽联合达格列净治疗。对比两组患者体质指数(BMI)、腰围(WC)、糖代谢水平、血压水平、脂代谢水平及胰岛功能。结果 观察组患者体质指数(BMI)、腰围(WC)较对照组显著下降,糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)等糖代谢水平较对照组更加趋近于正常值范围,差异有统计学意义(P<0.05);观察组患者舒张压(DBP)、收缩压(SBP)等血压水平及三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等脂代谢水平较对照组更加趋近于正常值范围,差异有统计学意义(P<0.05);观察组患者空腹胰岛素(FINS)、稳态胰岛素评价指数(HOMA-IR)、稳态胰岛β细胞分泌功能指数(HOMA-β)等胰岛功能指标较对照组更加趋近于正常值范围,差异有统计学意义(P<0.05)。结论肥胖2型糖尿病患者实施利拉鲁肽联合达格列净治疗,可显著改善BMI及WC指标、血糖血压水平,强化胰岛功能。

Objective To explore the feasibility of liraglutide combined with dapagliflozin in the treatment of obese type 2 diabetes(T2DM).Methods A total of 96 obese patients with type 2 diabetes who visited Chongqing High-tech Zone People’s Hospital from June 2020 to June 2021 were selected as the research objects.They were divided into control group and observation group by 1:1 ratio distribution method,with 48 cases in each group.The patients in the control group were treated with liraglutide,and the patients in the observation group were treated with liraglutide combined with dapagliflozin.The body mass index(BMI),waist circumference(WC),glucose metabolism,blood pressure,lipid metabolism and pancreatic islet function were compared between the two groups.Results The body mass index(BMI) and waist circumference(WC) of the patients in the observation group were significantly lower than those in the control group,and the levels of glucose metabolism such as glycosylated hemoglobin(HbA1c),fasting blood glucose(FPG),and 2 h postprandial blood glucose(2 hPG) were closer to the normal range than those in the control group,and the difference was statistically significant(P<0.05).The blood pressure levels such as diastolic blood pressure(DBP),systolic blood pressure(SBP) and lipid metabolism levels such as triacylglycerol(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C) and low-density lipoprotein cholesterol(LDL-C) in the observation group were closer to the normal range than those in the control group,and the difference was statistically significant(P<0.05).Compared with the control group,the islet function indexes such as fasting insulin(FINS),homeostasis insulin evaluation index(HOMA-IR) and homeostatic islet β cell secretory function index(HOMA-β) in the observation group were closer to the normal range,and the difference was statistically significant(P<0.05).Conclusion Liraglutide combined with dapagliflozin therapy in obese patients with type 2 diabetes can significantly improve BMI and WC indexes,blood glucose and blood pressure levels,and strengthen islet function.