达格列净对老年肥胖型2型糖尿病患者血糖波动、胰岛β细胞功能及体型的影响

Effects of dapagliflozin on blood glucose fluctuation,islet β cell function and body shape in elderly patients with obese type 2 diabetes mellitus

中文关键词: 老年  肥胖型2型糖尿病  达格列净  血糖  胰岛β细胞功能  体型  不良反应

英文关键词: elderly  obese type 2 diabetes mellitus  dapagliflozin  blood glucose  islet β-cell function  body shape  ad-verse reaction

中文摘要:

      目的 探讨达格列净用药方案在老年肥胖型2型糖尿病(T2DM)患者中的效果分析.方法 采用回顾性分析方式,研究对象为北京市普仁医院收治的老年肥胖型T2DM患者,选取2022年7月—2023年7月期间的86例进行研究,依照治疗方案差异分为观察组(n=46)和对照组(n=40).对照组给予利拉鲁肽治疗,观察组在与对照组相同治疗的基础上加用达格列净治疗,2组均连续治疗4周.比较2组患者血糖控制情况、胰岛β细胞功能、体型相关指标值(体型、体质量指数、内脏脂肪指数)、游离脂肪酸(FFA)水平、过氧化物酶体增殖物激活受体γ(PPARγ)水平,以及用药不良反应.结果 治疗后,相较于同组治疗前,2组患者血糖水平均下降(P＜0.05),观察组血糖水平低于对照组(P＜0.05);2组患者胰岛β细胞功能均上升(P＜0.05),观察组胰岛β细胞功能高于对照组(P＜0.05).治疗后,2组患者腰臀比、体质量指数(BMI)、内脏脂肪指数均低于同组治疗前(P＜0.05),观察组腰臀比、BMI及内脏指数均低于对照组(P＜0.05).治疗后,2组患者FFA水平均低于同组治疗前(P＜0.05)、PPARγ水平均高于同组治疗前(P＜0.05);观察组FFA水平低于对照组(P＜0.05)、PPARγ水平高于对照组(P＜0.05).观察组不良反应发生率与对照组比较,差异无统计学意义(P＞0.05).结论 针对老年肥胖型T2DM患者实施达格列净治疗,有利于提高血糖水平控制,改善体型指标,减少药物不良反应.

英文摘要:

      Objective To explore the effects of dapagliflozin treatment regimen in elderly patients with obese type 2 di-abetes mellitus(T2DM).Methods A retrospective analysis method was adopted.The research subjects were elderly patients with obese T2DM admitted to Beijing Puren Hospital.A total of 86 patients were selected from July 2022 to July 2023.Accord-ing to the differences in treatment regimens,they were divided into observation group(n=46)and control group(n=40).The control group was treated with liraglutide,while the observation group was treated with dapagliflozin on the basis of the same treatment as the control group.Both groups were treated continuously for 4 weeks.The blood glucose control condition,islet β-cell function,body shape-related indexes[body shape,body mass index(BMI),visceral fat index],free fatty acid(FFA)level,peroxisome proliferator-activated receptor γ(PPARγ)level,and adverse drug reactions were compared between the two groups.Results After treatment,compared with those in the same group before treatment,the blood glucose levels in both groups decreased(P＜0.05),and the observation group was lower than the control group(P＜0.05);the islet β-cell function in both groups increased(P＜0.05),and the observation group was higher than the control group(P＜0.05);the waist-hip ratio,BMI and visceral fat index in both groups were lower than those in the same group before treatment(P＜0.05),and the observation group was lower than the control group(P＜0.05).After treatment,the FFA levels in both groups were lower than those in the same group before treatment(P＜0.05),and the PPARγ levels were higher than those in the same group before treatment(P＜0.05);the FFA level in the observation group was lower than that in the control group(P＜0.05),and the PPARγ level was higher than that in the control group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion For elderly patients with obese T2DM,the implementation of dapagliflozin treatment is beneficial to improving the control level of blood glucose,improving body shape indexes,and reducing adverse drug reactions.