摘要
目的观察达格列净联合应用盐酸二甲双胍对2型糖尿病合并肥胖患者体内脂联素、瘦素水平的影响,探讨达格列净减轻体重的作用机制。方法选取2018年1月-12月期间在湛江中心人民医院内分泌科就诊的新诊断的2型糖尿病合并肥胖单独应用盐酸二甲双胍(500 mg 2次/d)3个月以上且血糖控制不佳的患者100例,随机分为观察组和对照组。对照组盐酸二甲双胍剂量增加至1000 mg、2次/天,观察组在对照组基础上联用达格列净10 mg、1次/天。16周后观察两组患者体重、腰围、空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)、体质量指数(BMI)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、HOMA-IR、脂联素(Adiponectin)和瘦素(Leptin)等指标的变化。结果与治疗前相比,两组患者治疗16周后FBG、2 h PBG、体重、腰围、BMI、Hb A1c、TG、TC、LDL-C、空腹胰岛素水平、Leptin水平较治疗前明显降低(P<0.05),观察组显著低于对照组(P<0.05)。治疗16周后观察组Adiponectin水平较治疗前明显上升(P<0.05),对照组Adiponectin水平较前有所上升,但差异无统计学差异(P>0.05)。结论达格列净可以通过改善脂肪细胞功能,促进脂联素分泌,改善瘦素抵抗从而改善胰岛素抵抗发挥减重作用。
Objective To observe the effect of dapagliflozin combined with metformin on the lever of adiponectin and leptin in obese patients with type 2 diabetes mellitus,and explore the mechanism of dapagliflozin control body Weight.Methods One hundred patients with obese patients with type 2 diabetes mellitus with poor blood sugar control in Central people’s hospital of Zhanjiang from January 2018 to December 2018 were treated with metformin alone(dose of 500 mg,2 times/d),taking more than 3 months.The patients were randomly divided into observation group and control group.The control group was given metformin(1000 mg,2 times/day),while the observation group was given metformin(1000 mg,2 times/day)combined with dapagliflozin(10 mg,1 time/day).The weight,waistline,fasting blood glucose(FBG),2 h postprandial blood glucose(2 hPBG),glycated hemoglobin(HbA1c),body mass index(BMI),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),triglyceride(TG),adiponectin,leptin and HOMA-IR were detected at the 16 weeks after the patients being treated.Results After 16 weeks of treatment,the levels of FBG,2 hPBG,weight,waistline,BMI,HbA1c,TG,TC,LDL-C,fasting insulin and leptin in both group significantly lower than before treatment(P<0.05),and the levels of FBG,2 hPBG,weight,waistline,BMI,TG,TC,LDL-C,leptin in observation group were lower than in control group(P<0.05).The levels of adiponectin in observation group were significantly higher than before treatment(P<0.05).The level of adiponectin increased in the control group,but the difference was not statistically significant(P>0.05).Conclusion Dapagliflozin may play a positive role in weight loss by alleviating insulin resistance through improving the function of adipocytes,promoting secretion of adiponectin and alleviating leptin resistance.
作者
宋青青
劳斌昌
黄春
赵燕妮
陈文俊
SONG Qingqing;LAO Bingchang;HUANG Chun;ZHAO Yanni;CHEN Wenjun(Central people s hospital of Zhanjiang,Zhanjiang 524037,China)
出处
《现代医院》
2020年第8期1215-1217,1220,共4页
Modern Hospitals
关键词
2型糖尿病
肥胖
达格列净
脂联素
瘦素
Type 2 Diabetes Mellitus
Obese Patients
Dapagliflozin
Leptin
Adiponectin
