西格列汀与二甲双胍联合对肥胖型糖尿病患者血糖及糖脂代谢的影响  

Effect of sitagliptin combined with metformin on blood glucose control and glucose and lipid metabolism in obese patients with diabetes mellitus

作　　者：朱秋根[1] 曾瑜 王梅丽 ZHU Qiugen;ZENG Yu;WANG Meili(Endocrinology Department,Ji'an Central People's Hospital,Ji'an Jiangxi 343000,China)

机构地区：[1]吉安市中心人民医院内分泌科,江西吉安343000

出　　处：《天津药学》2025年第2期174-177,共4页Tianjin Pharmacy

摘　　要：目的 探究西格列汀与二甲双胍联合对肥胖型糖尿病患者血糖控制及糖脂代谢的影响。方法 选取2022年4月至2024年4月吉安市中心人民医院接诊的80例肥胖型糖尿病患者,根据随机数字表法分为两组。对照组(n=40)予以二甲双胍治疗,观察组(n=40)在此基础上,加用磷酸西格列汀片治疗,两组均持续用药12周。对比两组临床疗效、血糖控制、糖脂代谢、胰岛功能以及不良反应。结果 观察组总有效率[97.50%(39/40)]高于对照组[77.50%(31/40)];治疗后,观察组空腹血糖[(6.05±1.15)mmol/L]、餐后2 h血糖[(7.12±1.13)mmol/L]、糖化血红蛋白[(6.41±0.72)%]低于对照组;观察组低密度脂蛋白(LDL)[(2.14±0.21)mmol/L]、甘油三酯(TG)[(1.35±0.24)mmol/L]、胆固醇(TC)[(4.18±0.50)mmol/L]低于对照组,高密度脂蛋白(HDL)[(2.18±0.14)mmol/L]高于对照组;观察组B细胞功能指数(HOMA-B)[(80.37±5.15)μg/L]高于对照组,空腹胰岛素(FINS)[(10.10±1.14)mU/L]、胰岛素抵抗指数(HOMA-IR)[(1.68±0.31)μU/mL]低于对照组(P<0.05);两组不良反应比较无统计学差异(P>0.05)。结论 西格列汀与二甲双胍联用治疗肥胖型糖尿病安全有效,能调血糖、促代谢、改善胰岛功能。Objective To explore the effect of sitagliptin combined with metformin on blood glucose control and glucose and lipid metabolism in obese patients with diabetes mellitus. Methods From April 2022 to April 2024, 80 obese patients with diabetes mellitus in Ji'an Central People's Hospital were randomly divided into two groups. The control group(40 cases) was treated with metformin, on this basis, the observation group(40 cases) was treated with sitagliptin phosphate tablets, both groups were treated for 12 weeks. The clinical efficacy, blood glucose control, glucose and lipid metabolism, islet function and adverse reactions were compared between the two groups. Results The total effective rate of the observation group was 97.50%(39/40), which was higher than the 77.50%(31/40) of the control group. After treatment, the fasting blood glucose, postprandial 2-hour blood glucose and glycated hemoglobin in the observation group [(6.05±1.15) mmol/L,(7.12±1.13) mmol/L,(6.41±0.72)%] were lower compared with the control group. The low-density lipoprotein(LDL), triglycerides(TG) and cholesterol(TC) of the observation group [(2.14±0.21) mmol/L,(1.35±0.24) mmol/L,(4.18±0.50) mmol/L] were lower compared to the control group. The observation group had higher high-density lipoprotein(HDL) [(2.18±0.14) mmol/L] and B cell function index(HOMA-B) [(80.37±5.15) μg/L] than those of the control group. Compared with the control group, the fasting insulin(FINS) and homeostasis model assessment of insulin resistance(HOMA-IR) in the observation group [(10.10±1.14) mU/L,(1.68±0.31) μU/mL] were lower(P<0.05);The adverse reactions of both groups were compared, which showed no statistical difference(P>0.05). Conclusion Sitagliptin combined with metformin in the treatment of obese diabetes mellitus is safe and effective, which can regulate blood glucose, promote metabolism and improve islet function.

关 键 词：肥胖型糖尿病 西格列汀 二甲双胍 血糖控制 糖脂代谢 

分 类 号：R587.1[医药卫生—内分泌]