达格列净联合二甲双胍对超重及肥胖2型糖尿病患者体脂含量及肌肉含量的影响

Effect of Dapagliflozin Combined with Metformin on Fat and Muscle Mass in Overweight and Obese Patients with Type 2 Diabetes

摘要: 目的：探究达格列净联合二甲双胍对超重及肥胖2型糖尿病患者体脂含量及肌肉含量的影响。方法：纳入于青岛大学附属医院门诊就诊并完成3个月随访的超重及肥胖2型糖尿病患者33例，分成两组，一组给予单用二甲双胍治疗作为对照组(13例)，另一组在二甲双胍的基础上联合达格列净治疗作为观察组(20例)。两组均进行糖尿病教育，连续用药3个月后评估两组治疗前、后的血糖指标[空腹血糖(FBG)、糖化血红蛋白(HbA1c)]及观察指标[体重、体重指数(BMI)、腰围、腰臀比、体脂含量、内脏脂肪指数(VFI)1、肌肉含量]的变化。结果：入组前，两组患者的FBG、HbA1c、体重、BMI、腰围、腰臀比、体脂含量、VFI、肌肉含量的基线值无显著差异(P > 0.05)。治疗3个月后，观察组的FPG、HbA1c较治疗前显著降低(P < 0.05)，对照组的FPG、HbA1c较治疗前降低未达到显著性差异(P > 0.05)；两组患者的体重、BMI、腰围、腰臀比、体脂含量、VFI较治疗前均显著降低(P < 0.05)；观察组与对照组的肌肉含量较治疗前降低未达到显著性差异(p ≥ 0.05)。结论：达格列净联合二甲双胍对超重及肥胖2型糖尿病患者的降糖效果明显优于单用二甲双胍，同时还具有减轻体重、减少体脂含量的作用，而对肌肉含量的减少未达到显著性差异。

Abstract: Objective: To investigate the effect of dapagliflozin combined with metformin on fat and muscle mass in overweight and obese patients with type 2 diabetes. Methods: A total of 33 overweight and obese patients with type 2 diabetes were recruited from the Outpatient Department of the Affiliat-ed Hospital of Qingdao University and followed up for 3 months, one group was treated with met-formin alone as control group (N = 13), and the other group was treated with metformin plus dapagliflozin as observation group (N = 20). Diabetes education was carried out in both groups, af-ter 3 months of continuous treatment, the blood glucose indexes [FBG, HbA1c], and observation in-dicators [body weight, body mass index (BMI), waist circumference, waist-to-hip ratio, body fat con-tent, visceral fat index (VFI), and muscle content] were evaluated before and after treatment in both groups. Results: The baseline values of FBG, HbA1c, body weight, BMI, waist circumference, waist-hip ratio, body fat content, VFI and muscle content were not significantly different between the two groups (P > 0.05). After treatment for 3 months, FPG and HbA1c in the observation group were significantly lower than those before treatment (P < 0.05), while in the control group, FPG and HbA1c were not significantly lower than those before treatment (P > 0.05); the body weight, BMI, waist circumference, waist-hip ratio, body fat content and VFI of the two groups were significantly lower than those before treatment (P < 0.05), and the muscle contents of the observation group and the control group were not significantly lower than those before treatment (P ≥ 0.05). Conclusions: Dapagliflozin combined with metformin is significantly better than metformin alone in reducing blood sugar in overweight and obese patients with type 2 diabetes, and has the effect of reducing weight and fat content, there was no significant reduction in muscle content.