度拉糖肽联合二甲双胍对肥胖型2型糖尿病患者机体代谢、体脂成分及血清脂肪因子的影响

Effects of dulaglutide combined with metformin on body metabolism,body fat composition and serum adipokines in obese patients with type 2 diabetes mellitus

目的 探究度拉糖肽联合二甲双胍在肥胖型2型糖尿病(T2DM)患者治疗中的临床疗效。方法 将2021年1月至2023年1月在上海市嘉定区安亭医院接受治疗的200例符合本课题筛选条件的肥胖型T2DM患者,随机分为利拉鲁肽组(n=100)和度拉糖肽组(n=100)。利拉鲁肽组给予利拉鲁肽联合二甲双胍治疗,度拉糖肽组给予度拉糖肽联合二甲双胍治疗,2组均治疗3个月。比较治疗前及治疗3个月机体代谢指标[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)]、体脂成分(体脂肪率、体重指数、四肢皮下脂肪率、内脏脂肪指数)及血清脂肪因子[脂联素(adiponectin)、神经肽Q(NPQ)、白脂素(asprosin)、鸢尾素(irisin)]水平;观察2组临床疗效及不良反应发生情况。结果 治疗3个月,2组FBG、2 h PBG、HbAlc、TC、TG、体脂肪率、体重指数、四肢皮下脂肪率、内脏脂肪指数、asprosin均较治疗前降低,且度拉糖肽组低于利拉鲁肽组(P<0.05)。治疗3个月后,2组血清adiponectin、NPQ、irisin水平均较治疗前升高,且度拉糖肽组升高幅度大于利拉鲁肽组(P<0.05)。度拉糖肽组有效率98.00%高于利拉鲁肽组91.00%(P<0.05)。2组不良反应发生率(11.00%、14.00%)相比,无统计学差异(P>0.05)。结论 度拉糖肽联合二甲双胍可改善肥胖型T2DM患者机体代谢状态,调节机体体脂成分及血清脂肪因子,临床疗效显著,安全性高。

Objective To explore the clinical efficacy of dulaglutide combined with metformin in the treatment of obese patients with type 2 diabetes mellitus(T2DM).Methods A total of 200 obese patients with T2DM who were treated in Shanghai Jiading District Anting Hospital from January 2021 to January 2023 were randomly divided into liraglutide group(n=100)and dulaglutide group(n=100).The liraglutide group was treated with liraglutide combined with metformin,and the dulaglutide group was treated with dulaglutide combined with metformin.Both groups were treated for 3 months.The body metabolic indexes[fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG),hemoglobin(HbA1 c),total cholesterol(TC),triglyceride(TG)],body fat composition[body fat rate,body mass index,subcutaneous fat rate of limbs,visceral fat index]and serum adipokines(adiponectin,neuropeptide Q(NPQ),asprosin,irisin)levels were compared before treatment and 3 months after treatment.The clinical efficacy and adverse reactions of the two groups were observed.Results After 3 months of treatment,FBG,2 h PBG,HbAlc,TC,TG,body fat rate,body mass index,subcutaneous fat rate of limbs,visceral fat index and asprosin in the two groups were lower than those before treatment,and those in the dulaglutide group were lower than those in the liraglutide group(P<0.05).After 3 months of treatment,the levels of serum adiponectin,NPQ and irisin in the two groups were higher than those before treatment,and the increase in the dulaglutide group was greater than that in the liraglutide group(P<0.05).The effective rate of dulaglutide group(98.00%)was higher than that of liraglutide group(91.00%)(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(11.00%,14.00%)(P>0.05).Conclusion Dulaglutide combined with metformin could improve the metabolic status of obese T2 DM patients,regulate body fat composition and serum adipokines,with significant clinical efficacy and safety.