摘要
目的探讨达格列净对新发老年2型糖尿病(T2DM)合并肥胖患者脂联素、瘦素、白介素-6(IL-6)及高敏C-反应蛋白(hs-CRP)等指标的影响。方法选取2019年12月至2020年10月福州市第一医院接诊的新发老年T2DM合并肥胖患者63例,所有患者均单独应用盐酸二甲双胍3个月以上且血糖控制不佳。患者用药盐酸二甲双胍剂量500 mg/d,3次/d,再联用达格列净10 mg/d,1次/d,持续治疗12周。对比分析治疗前、治疗12周后患者糖代谢、体重、脂联素、瘦素、IL-6及hs-CRP等指标变化情况。结果治疗前患者的FPG、2 hPG、HbAlc分别为(9.80±0.69)mmol/L、(12.98±1.62)mmol/L、(7.25±1.26)%,治疗12周后分别为(8.33±0.38)mmol/L、(10.58±0.47)mmol/L、(6.33±0.51)%,上述指标治疗后较治疗前均下降(P<0.001)。治疗前两组的BMI、WHR及体内脂肪百分比分别为(32.55±2.39)kg/m^(2)、(0.96±0.29)、(26.89±3.47)%,治疗12周后BMI、WHR及体内脂肪百分比分别为(30.03±1.05)kg/m^(2)、(0.71±0.22)、(22.08±2.66)%,均较治疗前明显降低(P<0.001)。治疗12周后的hs-CRP、瘦素、IL-6分别为(12.58±3.00)mg/L、(18.25±1.91)μg/L、(1.01±0.21)pg/ml,均低于治疗前的(30.00±5.47)mg/L、(37.01±3.42)μg/L、(2.10±0.26)pg/ml,脂联素水平12周后为(6.96±51.03)mg/L,高于治疗前的(2.80±0.63)mg/L,差异有统计学意义(P<0.001)。结论达格列净用于T2DM合并肥胖患者的治疗中,可改善其糖代谢情况,通过促进脂联素分泌,改善瘦素抵抗从而降低体重,并有效抑制炎症因子分泌。
Objective To investigate the effects of dapagliflozin on adiponectin,leptin,interleukin-6(IL-6)and high sensitivity C-reactive protein(hs-CRP)in elderly patients with type 2 diabetes mellitus(T2DM)complicated with obesity.Methods A total of 63 newly diagnosed elderly T2DM patients with obesity who were admitted to Fuzhou First Hospital from December 2019 to October 2020 were selected.All patients were treated with metformin hydrochloride alone for more than 3 months and had poor blood glucose control.The patient were given metformin hydrochloride at a dose of 500 mg/d,three times/d,followed by dapagliflozin at 10 mg/d,once/d,for 12 weeks.The changes of glucose metabolism,body weight,adiponectin,leptin,IL-6 and hs-CRP before and after treatment for 12 weeks were compared and analyzed.Results Before treatment,FPG,2 hPG and HbAlc were(9.80±0.69)mmol/L,(12.98±1.62)mmol/L,and(7.25±1.26)%,respectively;after 12 weeks of treatment,they were(8.33±0.38)mmol/L,(10.58±0.47)mmol/L,and(6.33±0.51)%,respectively;the above indexes were all decreased after treatment compared with before treatment(P<0.001).Before treatment,the BMI,WHR and body fat percentage were(32.55±2.39)kg/m^(2),(0.96±0.29),(26.89±3.47)%,respectively;after 12 weeks of treatment the BMI,WHR and body fat percentage were(30.03±1.05)kg/m^(2),(0.71±0.22)and(22.08±2.66)%,respectively,which were significantly lower than those before treatment(P<0.001).After 12 weeks of treatment,hs-CRP,leptin,IL-6 were(12.58±3.00)mg/L,(18.25±1.91)μg/L,and(1.01±0.21)pg/ml,respectively,which were lower than(30.00±5.47)mg/L,(37.01±3.42)μg/L,and(2.10±0.26)pg/ml before treatment,with statistically significant differences.The adiponectin level after 12 weeks of treatment was(6.96±51.03)mg/L,which was higher than that before treatment(2.80±0.63)mg/L,and the difference was statistically significant(P<0.001).Conclusion The application of dapagliflozin in the treatment of T2DM patients with obesity can improve their glucose metabolism,reduce body weight by promoting adipon
作者
陈霖
傅强
林龙仔
林威
冯亚萍
CHEN Lin;FU Qiang;LIN Longzai;LIN Wei;FENG Yaping(Department of Geriatrics,Fuzhou First Hospital,Fuzhou 350004,China)
出处
《中国现代医生》
2022年第6期5-7,19,共4页
China Modern Doctor
关键词
2型糖尿病
肥胖
达格列净
脂联素
瘦素
白介素
高敏C-反应蛋白
Type 2 diabetes mellitus
Obesity
Dapagliflozin
Adiponectin
Leptin
Interleukin
High sensitivity C-reactive protein
