度拉糖肽联合达格列净对超重和肥胖2型糖尿病患者糖脂代谢及内脏脂肪的影响

Effects of Glucose and Lipid Metabolism and Visceral Fat in Overweight and Obese Patients with Type 2 Diabetes Mellitus Treated with Dulaglutide Combined with Dapagliflozin

摘要: 目的：探讨度拉糖肽联合达格列净对超重和肥胖2型糖尿病患者糖脂代谢及内脏脂肪的影响。方法：选取2022年1月至2023年1月于十堰市人民医院内分泌科门诊及住院治疗的2型糖尿病患者80例，根据体重指数分为超重组(n = 40)、肥胖组(n = 40)，两组均采用度拉糖肽联合达格列净治疗，连续治疗16周，比较两组患者治疗前后的空腹血糖(FBG)、餐后2小时血糖(2 h PG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、体重、腰臀比(WHR)、体重指数(BMI)、内脏脂肪面积(VFA)及内脏脂肪指数(VAI)的变化情况，并记录观察期间不良反应的发生情况。结果：治疗前两组患者各项指标比较差异均无统计学意义(P > 0.05)。治疗16周后，两组患者FBG、2 h PG、HbA1c、TC、TG、LDL-C、体重、WHR、BMI、VFA及VAI均低于同组治疗前，HDL-C均高于同组治疗前，且肥胖组患者FBG、2 h PG、HbA1c、体重、WHR、BMI、VFA、VAI下降程度均优于超重组，治疗后两组在TC、TG、LDL-C、HDL-C方面无显著差异(P > 0.05)。结论：度拉糖肽联合达格列净可以有效降低超重和肥胖T2DM患者VFA及VAI，且对肥胖患者疗效更好。

Abstract: Objective: To explore the effect of dulaglutide combined with daggligin on glucose and lipid metabolism and visceral fat in overweight and obese type 2 diabetes patients. Methods: Eighty patients with type 2 diabetes who were treated in the outpatient and inpatient departments of the Endocrine Department of Shiyan People’s Hospital from January 2022 to January 2023 were selected. According to body mass index, they were divided into super recombinant (n = 40) and obese group (n = 40). Both groups were treated with dulaglutide and dagelin for 16 consecutive weeks. Fasting blood glucose (FBG), 2-hour postprandial blood glucose (2 h PG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) before and after treatment were compared between the two groups. Body weight, waist hip ratio (WHR), body mass index (BMI), visceral fat area (VFA) and visceral fat index (VAI), and the occurrence of adverse reactions during the observation period were recorded. Result: There was no statistically significant difference in various indicators between the two groups of patients before treatment (P > 0.05). After 16 weeks of treatment, the FBG, 2 h PG, HbA1c, TC, TG, LDL-C, body weight, WHR, BMI, VFA, and VAI of both groups of patients were lower than before treatment in the same group, while HDL-C was higher than before treatment in the same group. In addition, the degree of FBG, 2 h PG, HbA1c, body weight, WHR, BMI, VFA, and VAI decrease in the obese group was better than that in the overweight group. There was no significant difference in TC, TG, LDL-C, and HDL-C between the two groups after treatment (P > 0.05). Conclusion: Dulaglutide combined with dapagliflozin can effectively reduce VFA and VAI in overweight and obese T2DM patients, and has better therapeutic effects on obese patients.