山东大学学报 (医学版) ›› 2019, Vol. 57 ›› Issue (6): 87-93.doi: 10.6040/j.issn.1671-7554.0.2019.253
• • 上一篇
姜立娟,刘福强,蒋子允,李文娟,林鹏,王川,侯新国,陈丽
JIANG Lijuan, LIU Fuqiang, JIANG Ziyun, LI Wenjuan, LIN Peng, WANG Chuan, HOU Xinguo, CHEN Li
摘要: 目的 评价钠-葡萄糖协同转运蛋白-2(SGLT-2)抑制剂对超重及肥胖2型糖尿病患者的各项体脂参数的影响,探究其对脂代谢及内脏脂肪的影响及可能机制。 方法 随机选取入院前血糖控制不佳的2型糖尿病住院患者60例,男46例,女14例,35~65岁,平均50岁。随机分为对照组和达格列净(安达唐)治疗组,每组30例。两组均进行糖尿病教育,对照组调整胰岛素或口服降糖药方案或联用非SGLT-2抑制剂,治疗组在原有口服降糖药和或胰岛素治疗基础上加用达格列净,1次/d,10 mg/次,共12周。记录两组年龄、性别、血糖、糖化血红蛋白、血脂指标、体成分基线值及治疗12周后值,达格列净治疗组24 h尿糖定量及电解质,血生化指标的基线值及治疗12周后值,同时记录两组治疗期间不良反应的发生率包括尿路感染、生殖道感染、低血糖及肾功能异常。 结果 两组性别比例、年龄、血糖、糖化血红蛋白、体质量等基线值差异无统计学意义(P>0.05)。12周治疗后,两组血糖均得到有效控制(P<0.01)。在血脂参数中,达格列净显著降低甘油三酯(P<0.05),增加高密度脂蛋白(P<0.01),对胆固醇及低密度脂蛋白无显著影响(P>0.05)。对照组在治疗期内血脂无明显变化(P>0.05)。治疗期间内达格列净显著降低患者内脏脂肪面积、内脏脂肪量(P<0.01),对体质量、全身脂肪百分比、四肢骨骼肌指数、骨矿含量等身体成分无显著影响(P>0.05);同时达格列净治疗组24 h尿糖定量显著增加(P<0.01),24 h尿液中电解质无显著差异(P>0.05),对血电解质、血常规及肾功也无影响(P>0.05)。治疗期内,达格列净治疗组不良反应与对照组差异无统计学意义(P>0.05)。 结论 达格列净显著降低2型糖尿病的血糖值,并且显著降低糖尿病患者的甘油三酯、内脏脂肪面积、内脏脂肪量,增加高密度脂蛋白,降低心血管疾病的危险因素,且对肾功、电解质均无显著影响,不增加肾功能损害及低血糖的发生率,是一种安全有效的治疗药物。
中图分类号:
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