摘要
目的观察司美格鲁肽和沙格列汀分别与二甲双胍联用治疗2型糖尿病(T2DM)伴腹型肥胖(AO)的疗效和安全性。方法回顾性分析T2DM伴AO患者的病历资料,按队列法分为司美格鲁肽组和沙格列汀组。2组患者均口服二甲双胍,每次0.5 g,每天3次;司美格鲁肽组在二甲双胍治疗的基础上注射司美格鲁肽,每次0.25 mg,2周后调整剂量为每次0.5 mg,均每周1次;沙格列汀组在二甲双胍治疗的基础上口服沙格列汀,每次5 mg,每天1次,均治疗3个月。比较2组患者的糖代谢指标、胰岛功能指标、脂肪因子及药物不良反应。结果司美格鲁肽组48例和沙格列汀组49例。治疗后,司美格鲁肽组和沙格列汀组的空腹血糖(FPG)分别为(7.45±1.22)和(7.98±1.30)mmol·L^(-1),餐后2 h血糖(2 hPG)分别为(9.78±1.64)和(10.55±1.82)mmol·L^(-1),糖化血红蛋白(HbA1c)分别为(5.66±0.94)%和(6.25±0.87)%,空腹胰岛素(FINS)分别为(29.12±6.46)和(34.34±7.15)pmol·L^(-1),空腹C肽(FC-P)分别为(292.66±67.53)和(319.03±77.92)pmol·L^(-1),胰岛素抵抗指数(HOMA-IR)分别为2.51±0.78和2.94±0.89,胰岛素分泌指数(HOMA-β)分别为51.74±15.31和43.72±14.56,血清鸢尾素(Irisin)分别为(4.56±0.32)和(4.17±0.54)ng·L^(-1),血清神经肽(SPX)分别为(0.71±0.15)和(0.64±0.17)ng·mL^(-1),血清白脂素(ASP)分别为(1.22±0.16)和(1.34±0.25)μg·L^(-1),在统计学上差异均有统计学意义(均P<0.05)。司美格鲁肽组和沙格列汀组的总药物不良反应发生率分别为10.42%(5例/48例)和2.04%(1例/49例),在统计学上差异无统计学意义(P>0.05)。结论司美格鲁肽联合二甲双胍治疗T2DM伴AO患者可以更显著地降低血糖,改善胰岛功能和脂肪因子,安全性良好。
Objective To observe the effects and safety of semaglutide and saxagliptin combined with meformin in the treatment of type 2 diabetes mellitus(T2DM)with abdominal obesity(AO).Methods The data of patients with T2DM and AO were retrospectively analyzed.Patients with T2DM and AO were divided into semaglutide group and saxagliptin group according to the cohort method.Both groups were given metformin orally,0.5 g a time,tid.On this basis,the semaglutide group was injected with semaglutide,0.25 mg a time,2 weeks later,the dose was adjusted to 0.5 mg a time,qw.The saxagliptin group was given oral administration of saxagliptin on the basis of metformin,5 mg a time,qd.All patients received 3 months of treatment.Glucose metabolism indexes,pancreatic islet function indexes,adipokines and adverse drug reactions were compared between the groups.Results There were 48 cases in semaglutide group and 49 cases in saxagliptin group.After treatment,the levels of fasting plasma glucose(FPC)in the semaglutide group and the saxagliptin group were(7.45±1.22)and(7.98±1.30)mmol·L^(-1);the levels of 2 h plasma glucose(2 h PG)were(9.78±1.64)and(10.55±1.82)mmol·L^(-1);the levels of hemoglobin A1c(HbA1c)were(5.66±0.94)and(6.25±0.87)%;the levels of fasting insulin(FINS)were(29.12±2.46)and(34.34±7.15)pmol·L^(-1);the levels of fasting C-peptide(FC-P)were(292.66±67.53)and(319.03±77.92)pmol·L^(-1);homeostatic model assessment-insulin resistance(HOMA-IR)were 2.51±0.78 and 2.94±0.89;homeostatic model assessment-β(HOMA-β)were 51.74±15.31 and 43.72±14.56;levels of Irisin were(4.56±0.32)and(4.17±0.54)ng·L^(-1);the levels of spexin(SPX)were(0.71±0.15)and(0.64±0.17)ng·mL^(-1);the levels of asprosin(ASP)were(1.22±0.16a)nd(1.34±0.25)μg·L^(-1).The above indexes were significantly different between semaglutide group and saxagliptin group(all P<0.05).The total incidence rates of adverse drug reactions in semaglutide group and saxagliptin group were 10.42%(5 cases/48 cases)and 2.04%(1 case/49 cases),without statistically significa
作者
刘永菊
李瑞
郝娜娜
李婉婉
LIU Yong-ju;LI Rui;HAO Na-na;LI Wan-wan(Department of Endocrinology,Fuyang Hospital of Anhui Medical University,Fuyang 236000,Anhui Province,China)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2024年第10期1400-1404,共5页
The Chinese Journal of Clinical Pharmacology
