司美格鲁肽联合达格列净对2型糖尿病合并代谢综合征患者腹部脂肪分布及血清Asprosin、Spexin水平的影响  

Effects of semaglutide combined with dagliprazin on abdominal fat distribution and serum Asprosin and Spexin levels in patients with type 2 diabetes mellitus complicated with metabolic syndrome

作　　者：乙丰收 吴胜利 伊力哈木 毛玉琴 Yi Fengshou;Wu Shengli;Ilham;Mao Yuqin(Department of Endocrine Nephrology,Karamay Integrated Hospital of Traditional Chinese and Western Medicine(Municipal People's Hospital),Xinjiang,Karamay 834000,China)

机构地区：[1]新疆克拉玛依市中西医结合医院(市人民医院)内分泌肾病科,834000

出　　处：《疑难病杂志》2025年第4期423-427,433,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：新疆维吾尔自治区自然科学基金资助项目(2021D01C404);四大慢病重大专项(2023ZD0508100)。

摘　　要：目的探讨司美格鲁肽联合达格列净对2型糖尿病(T2DM)合并代谢综合征(MS)患者腹部脂肪分布及血清白脂素(Asprosin)、Spexin水平的影响。方法选取2022年1月—2024年1月新疆克拉玛依市中西医结合医院(市人民医院)内分泌肾病科诊治T2DM合并MS患者104例,按治疗方案不同分为2组。以接受达格列净治疗的患者52例为对照组,以接受司美格鲁肽联合达格列净治疗的患者52例为观察组,均治疗3个月,比较2组治疗前后糖代谢指标[空腹血糖(FPG)、糖化血红蛋白(HbA_(1c))]、胰岛功能相关指标[胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)]、脂代谢指标[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、体质量、内脏脂肪面积(VFA)、皮下脂肪面积(SFA)、血清Asprosin与Spexin水平及不良反应发生率。结果与治疗前比较,治疗3个月后2组FPG、HbA_(1c)降低,且观察组低于对照组(t/P=4.579/<0.001,4.714/<0.001);2组HOMA-IR较治疗前降低,HOMA-β较治疗前升高,且观察组降低/升高幅度大于对照组(t/P=6.109/<0.001,6.771/<0.001);2组TC、TG、LDL-C较治疗前降低,HDL-C较治疗前升高,且观察组降低/升高幅度大于对照组(t/P=4.725/<0.001,7.748/<0.001,4.647/<0.001,6.596/<0.001);2组体质量、VFA及SFA较治疗前降低,且观察组低于对照组(t/P=2.363/0.020,6.089/<0.001,4.116/<0.001);2组血清Asprosin水平较治疗前降低,血清Spexin水平较治疗前升高,且观察组降低/升高大于对照组(t/P=6.111/<0.001,5.007/<0.001);2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论司美格鲁肽联合达格列净治疗T2DM合并MS患者,可调节血清Asprosin、Spexin水平,改善糖脂代谢及胰岛素抵抗,同时可以降低体质量及VFA、SFA,且安全性高。Objective To investigate the effects of Semiglutide combined with dagliprazin on abdominal fat distribution and serum Asprosin and Spexin levels in type 2 diabetes mellitus(T2DM)patients with metabolic syndrome(MS).Methods From January 2022 to January 2024,104 patients with T2DM combined with MS were diagnosed and treated in the Department of Endocrinology and Nephrology of Karamay Integrated Hospital of Traditional Chinese and Western Medicine(Municipal People's Hospital),and divided into 2 groups according to different treatment plans.A total of 52 patients were treated with dagliprazin as control group,and 52 patients were treated with semaglutide combined with dagliprazin as observation group.Glucose metabolism indexes[fasting blood glucose(FPG),glycated hemoglobin(HbA_(1c))],islet function related indexes[insulin resistance index(HOMA-IR),islet beta cell function index(HOMA-β)],lipid metabolism indexes[total cholesterol(TC),triacylglycerol(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),body mass,visceral fat area(VFA),subcutaneous fat area(SFA),serum Asprosin and Spexin levels,and incidence of adverse reactions before and after treatment were compared between the two groups.Results Compared with before treatment,FPG and HbA_(1c) decreased in 2 groups after treatment.In the observation group,the reduction was greater(t/P=4.579/<0.001,4.714/<0.001).HOMA-IR decreased and HOMA-βincreased in 2 groups after treatment,the change range of the observation group was greater(t/P=6.109/<0.001,6.771/<0.001).After treatment,TC,TG and LDL-C were decreased and HDL-C was increased in 2 groups,the decrease/increase of the observation group was greater(t/P=4.725/<0.001,7.748/<0.001,4.647/<0.001,6.596/<0.001);After treatment,body mass,VFA and SFA decreased in 2 groups,the reduction rate of the observation group was greater(t/P=2.363/0.020,6.089/<0.001,4.116/<0.001);After treatment,serum Asprosin level decreased and serum Spexin level increased in 2 groups,the decrease/increase of th

关 键 词：2型糖尿病 代谢综合征 司美格鲁肽 达格列净 腹部脂肪分布 白脂素 Spexin 

分 类 号：R587.1[医药卫生—内分泌]