达格列净对冠心病合并2型糖尿病患者心外膜脂肪衰减值的影响

Effect of dapagliflozin treatment on epicardial fat attenuation in patients with coronary heart disease and type 2 diabetes mellitus

目的观察达格列净对冠心病合并2型糖尿病患者心外膜脂肪衰减值(EFat)的影响。方法回顾性选取我院住院的冠心病合并2型糖尿病患者,分为试验组和对照组。对照组维持原降糖治疗、未使用达格列净,试验组在原治疗基础上新加用达格列净10 mg·d^(-1),口服;中位随访13个月。比较2组在治疗前和治疗后体质量指数(BMI)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、三酰甘油、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)及EFat的变化。结果入选235例患者,完成随访205例。试验组111例,对照组94例。试验组患者BMI、FBG、HbA1c均较服药前显著下降,HDL-C较服药前显著升高。治疗后试验组患者EFat较基线明显降低[(-96.48±14.71)HU vs(-88.59±10.60)HU,P<0.05]。相关分析表明,试验组患者EFat变化与HDL-C的变化呈负相关(r=-0.188,P<0.05)。结论在冠心病合并2型糖尿病患者中,达格列净可降低BMI、FBG、HbA1c,并能降低EFat值。

Objective To analyze the effect of dapagliflozin on epicardial fat attenuation(EFat)in patients with coronary heart disease and type 2 diabetes.Methods The patients with coronary heart disease and type 2 diabetes in our hospital were retrospectively collected.The patients were grouped into treatment group and control group.The treatment group was newly treated with dapagliflozin on the basis of the original treatment.The control group maintained the original antidiabetic drugs without using dapagliflozin.After median follow-up of thirteen months,the clinical characteristics,including body mass index(BMI),fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),triglycerides,total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),and EFat between the two groups were compared.Results A total of 235 patients were collected,of which 205 cases completed follow-up.There were 111 cases in the treatment group and 94 cases in the control group.The BMI,FBG and HbA1c of patients in the treatment group significantly decreased compared to those before therapy,while HDL-C significantly increased.The EFat of patients in the treatment group significantly decreased compared to baseline[(-96.48±14.71)HUvs(-88.59±10.60)HU,P<0.05].Pearson correlation analysis showed a negativecorrelation between changes in EFat and changes in HDL-C in patients in the treatment group(r=-0.188,P<0.05).Conclusion Dapagliflozin can reduce the epicardial fat attenuation in patients with coronary heart diseaseand type 2 diabetes.