司美格鲁肽对肥胖2型糖尿病患者皮肤微循环功能的影响

Effect of semaglutide on skin microcirculatory function in obese patients with type 2 diabetes mellitus

目的探讨司美格鲁肽对肥胖2型糖尿病(T2DM)患者的皮肤微循环功能的影响。方法回顾性分析2022年6月至2023年1月诊断为2型糖尿病且合并肥胖,并于广州市皮肤病防治所门诊就诊的患者共94例,根据是否使用司美格鲁肽控制血糖分为观察组和对照组,其中使用司美格鲁肽联合二甲双胍控制血糖的(观察组)共44例,采用二甲双胍控制血糖的共50例(对照组),对比两组患者的BMI、血脂、血糖相关代谢指标的水平,用激光多普勒血流检测仪对两组患者在干预前和干预后3个月腹部脐周皮肤微循环功能进行检测。结果在干预3个月后,观察组的空腹血糖(FPG)、餐后2 h血糖(2hPG)、BMI值和糖化血红蛋白(HbAlc)水平均低于对照组,而C肽水平显著高于对照组(P<0.05);观察组在的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)水平均低于对照组,差异有统计学意义;而HDL-C水平显著高于对照组(P<0.05)。观察组的血细胞平均运动速度(AVBC)、运动血细胞浓度(CMBC)、微血管血流灌注量(MBP)和经皮氧分压(TcpO2)水平显著高于对照组(P<0.05)。结论司美格鲁肽不仅能改善肥胖2型糖尿病患者的糖脂代谢,也能改善患者的皮肤微循环状态。

Objective To investigate the effect of semaglutide on skin microcirculation function in obese patients with type 2 diabetes mellitus.Methods A total of 94 patients with obesity diagnosed with type 2 diabetes mellitus from June 2022 to January 2023 were retrospectively analyzed in Guangzhou Institute of Dermatology and Prevention.According to whether or not to control blood sugar with smeagoutide,they were divided into observation group and control group,in which 44 patients were treated with smeagoutide combined with metformin,and 50 patients were treated with metformin.The levels of body mass index(BMI),blood lipid and blood glucose-related metabolic indexes of the two groups were compared,and the blood glucose was measured by laser Doppler blood flow detector(LDF).Results After three months of intervention,FPG,2hPG,BMI and HbAlc levels in the observation group were lower than those in the control group,while the level of C peptide was significantly higher than that in the control group(P<0.05).The levels of total cholesterol(TC),triglyceride(TG)and low density lipoprotein(LDL-C)in the observation group were significantly lower than those in the control group,while the level of HDL-C was significantly higher than that in the control group(P<0.05).The average blood cell velocity(AVBC),exercise blood cell concentration(CMBC),microvascular blood perfusion(MBP)and percutaneous oxygen partial pressure(TcpO2)in the observation group were significantly higher than those in the control group(P<0.05).Conclusions Semaglutide can not only improve the glucose and lipid metabolism of obese patients with type 2 diabetes mellitus,but also improve the skin microcirculation.