达格列净对超重2型糖尿病患者内脏脂肪指数的影响

Effect of Dapagliflozin on Visceral Fat Index in Overweight Type 2 Diabetes Patients

摘要: 目的：探讨达格列净对超重2型糖尿病患者内脏脂肪指数的影响。方法：随机选取入院前血糖控制不佳的2型糖尿病患者共184例，根据随机数字法将患者分为对照组和达格列净组，各92例，两组患者均进行糖尿病教育，对照组调整胰岛素或口服降糖药或其他非SGLT-2i，观察组在原有胰岛素或口服降糖药物的基础上加用达格列净，1次/d，10 mg/次，随访52~64周，记录患者性别、年龄及治疗前后体重、BMI、腰围、臀围、空腹血糖、糖化血红蛋白、TC、TG、LDL-C、尿酸、肌酐、VAI水平变化，其中观察组中3例患者因不良反应停药，最终181例患者完成研究。结果：两组患者治疗前年龄、性别、体重、BMI、腰围、臀围、空腹血糖、糖化血红蛋白、TC、TG、HDL-C、LDL-C、尿酸、肌酐、VAI水平无差别(p > 0.05)，治疗52~64周后，两组患者体重、BMI、腰围均较前下降，差异有统计学意义(p < 0.05)，TC、LDL-C较前无显著变化(p > 0.05)。达格列净可显著降低患者臀围、空腹血糖、糖化血红蛋白、TG (p < 0.05)，增加HDL-C水平(p < 0.05)，两组患者治疗后VAI水平均下降，达格列净组下降水平高于对照组，差异有统计学意义(p < 0.05)，两组患者治疗后，尿酸、肌酐变化差异无统计学意义。结论：达格列净可改善患者脂代谢，改善患者内脏脂肪功能。

Abstract: Objective: To investigate the effect of dapagliflozin on visceral fat index in overweight type 2 diabe-tes patients. Methods: 184 patients with type 2 diabetes who had poor blood glucose control before admission were randomly selected. According to the random number method, the patients were di-vided into the control group and the dapagliflozin group, with 92 patients in each group. Both groups received diabetes education. The control group adjusted insulin or took oral hypoglycemic drugs or other non SGLT-2i. The observation group added dapagliflozin based on the original insulin or oral hypoglycemic drugs, 10 mg/d, followed up for 52~64 weeks, and the patient’s gender, age and changes in body weight, BMI, waist circumference, hip circumference, fasting blood glucose, glycosylated hemoglobin, TC, TG, LDL-C, uric acid, creatinine and VAI levels before and after treat-ment were recorded. Three patients in the observation group stopped taking the drug due to ad-verse reactions, and 181 patients finally completed the study. Results: There was no difference in age, sex, weight, BMI, waist circumference, hip circumference, fasting blood glucose, glycosylated hemoglobin, TC, TG, HDL-C, LDL-C, uric acid, creatinine and VAI levels between the two groups before treatment (p > 0.05). After 52~64 weeks of treatment, the weight, BMI and waist circumference of the two groups decreased compared with that before treatment (p < 0.05), and TC and LDL-C had no significant changes compared with that before treatment (p > 0.05). Dapagliflozin can significantly reduce the hip circumference, fasting blood glucose, glycosylated hemoglobin, TG (p < 0.05), and in-crease the HDL-C level (p < 0.05). After treatment, the VAI level of the two groups of patients de-creased. The decline level of dapagliflozin group was higher than that of the control group, with a statistically significant difference (p < 0.05). After treatment, there was no statistically significant difference in the changes of uric acid and creatinine between the two groups of patients. Conclusion: Dapagliflozin can improve lipid metabolism and visceral fat function in patients.