磷酸西格列汀联合二甲双胍对T2DM伴轻度肥胖患者胰岛β细胞功能及脂代谢的影响  

Influence of sitagliptin phosphate combined with metformin on islet β cell function and lipid metabolism in patients with type 2 diabetes mellitus and mild obesity

作　　者：高原 姚婷 万明 王家丽 孙秋 GAO Yuan;YAO Ting;WAN Ming;WANG Jiali;SUN Qiu(Department of Endocrinology,The Second Affiliated Hospital of Chengdu Medical College,Nuclear Industry 416 Hospital,Chengdu 610000,China)

机构地区：[1]成都医学院第二附属医院·核工业四一六医院内分泌科,四川成都610000

出　　处：《西部医学》2023年第10期1501-1505,共5页Medical Journal of West China

基　　金：四川省医学(青年创新)科研课题(S20083)。

摘　　要：目的探讨磷酸西格列汀联合二甲双胍对2型糖尿病(T2DM)伴轻度肥胖患者的临床效果及对患者胰岛β细胞功能的影响。方法纳入我院2018年7月—2022年4月收治的184例T2DM伴轻度肥胖患者,采用随机数字表法分为A组(61例,二甲双胍治疗)、B组(61例,西格列汀治疗)和C组(62例,二甲双胍与西格列汀联合治疗),3组疗程均为3个月,比较3组治疗后血糖、血脂、脂肪因子、胰岛β细胞功能等指标变化以及不良反应发生情况。结果治疗后3组患者空腹血糖(FBG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、总胆固醇(TC)以及低密度脂蛋白(LDL-C)均明显降低(P<0.05),且C组FBG、2hPG、HbA1c、TG、TC及LDL-C低于A组和B组,差异有统计学意义(均P<0.05);3组空腹胰岛素(FIns)和胰岛β细胞功能指数(HOMA-β)明显升高,稳态模型胰岛素抵抗(HOMA-IR)明显降低(均P<0.05),且A组FIns低于B组和C组,C组HOMA-β高于A组和B组,HOMA-IR低于A组和B组,差异有统计学意义(均P<0.05);3组瘦素和抵抗素明显降低,脂联素明显升高,且C组瘦素及抵抗素水平低于A组和B组,脂联素水平高于A组和B组(均P<0.05);3组治疗期间体质量指数(BMI)变化及不良反应发生情况未见明显差异(P>0.05)。结论磷酸西格列汀联合二甲双胍治疗轻度肥胖T2DM患者可有效降低血糖、血脂及脂肪因子水平,改善患者胰岛β细胞功能。Objective To study the clinical effects of sitagliptin phosphate combined with metformin in the treatment of patients with type 2 diabetes mellitus(T2DM)complicated mild obesity and its influence on isletβcell function.Methods 184 patients with T2DM complicated with mild obesity in the hospital from July 2018 to April 2022 were divided into group A(n=61,metformin),group B(n=61,sitagliptin)and group C(n=62,combined treatment)according to the random number table method.The three groups were treated for 3 months.The changes of blood glucose,blood lipids,adipokines and isletβcell function and the occurrence of adverse reactions were compared among the three groups after treatment.Results After treatment,the fasting blood glucose(FBG),2h postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)were significantly decreased in the three groups(P<0.05),and the FBG,2hPG,HbA1c,TG,TC and LDL-C in group C were lower than those in groups A and B(P<0.05).The fasting insulin(FIns)and isletβcell function index(HOMA-β)were significantly increased in the three groups(P<0.05)while the homeostasis model assessment of insulin resistance(HOMA-IR)was significantly decreased(P<0.05),and the fasting insulin in group A was lower than that in groups B and C,and the HOMA-βin group C was higher than that in groups A and B while the HOMA-IR was lower than that in groups A and B(P<0.05).The levels of leptin and resistin were significantly decreased in the three groups(P<0.05)while the adiponectin level was significantly increased(P<0.05),and the levels of leptin and resistin in group C were lower than those in groups A and B while the level of adiponectin was higher than that in groups A and B(P<0.05).There were no significant differences in body mass index(BMI)changes and adverse reactions during treatment among the three groups(P>0.05).Conclusion Sitagliptin phosphate combined with metformin for patients with mild obesity and T2DM can effectively

关 键 词：2型糖尿病 轻度肥胖 磷酸西格列汀 二甲双胍 胰岛Β细胞 

分 类 号：R587.1[医药卫生—内分泌]