摘要
目的 观察达格列净对2型糖尿病(type 2 diabetes mellitus,T2DM)合并冠心病患者的血清网膜素-1、心外膜脂肪组织(epicardial adipose tissue,EAT)厚度的影响。方法 选取2020年7月至2022年6月内蒙古科技大学包头医学院第二附属医院收治的100例T2DM合并冠心病患者作为研究对象。按照治疗药物不同随机分为两组,观察组50例,给予二甲双胍(1.0~1.5 g/d)±口服降糖药物/胰岛素+达格列净10 mg/d;对照组50例,给予二甲双胍(1.0~1.5 g/d)±口服降糖药物/胰岛素。治疗24周后,观察两组血清网膜素-1、EAT厚度、体质量、腰围、体质量指数(body mass index,BMI)、血压、空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(hemoglobin A_(1C),HbA_(1C))、胰岛素抵抗指数(homeostasis model evaluation-insulin rsistance,HOMA-IR)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、血尿酸、尿白蛋白肌酐比变化;分析达格列净对EAT厚度及血清网膜素-1的影响。结果 入组时两组各指标比较,差异无统计学意义(P>0.05);达格列净治疗24周后,观察组体质量、BMI、腰围、收缩压、FPG、HbA_(1c)、HOMA-IR、血尿酸、尿白蛋白肌酐比、TG、TC、EAT厚度较治疗前明显下降,差异有统计学意义(P<0.05);血清网膜素-1和HDL-C显著升高,差异有统计学意义(P<0.05);观察组EAT厚度、网膜素-1和HDL-C水平变化较对照组更显著。多因素线性回归分析结果显示,网膜素-1是EAT的独立危险因素,回归方程:Y_(EAT厚度)=3.893-0.017×X_(网膜素-1)+0.078×X_(HOMA-IR)+0.148×X_(LDL-C)+0.008×X_(腰围)(R^(2)=0.789,F=42.46,P<0.05)。结论 血清网膜素-1是EAT厚度的独立影响因素,达格列净可升高T2DM合并CAD患者血清网膜素-1水平减轻胰岛素抵抗,从而减少EAT厚度,发挥血管病保护作用。
Objective To analyze the effects of dapagliflozin on serum omentin-1 and epicardial adipose tissue(EAT)thickness in patients with type 2 diabetes mellitus(T2DM)and coronary artery disease(CAD).Methods One hundred patients with T2DM and CAD were enrolled in the study.The patients were randomly divided into two groups:50 patients in the observation group were treated with metformin(1.0-1.5 g/d)±oral hypoglycemic drugs/insulin+dapagliflozin(10 mg/d);and 50 patients in the control group were treated with metformin(1.0~1.5 g/d)±oral hypoglycemic drugs/insulin.After 24 weeks of treatment,the serum omentin-1 level,EAT thickness,body weight,waist circumference(WC),body mass index(BMI),blood pressure,fasting plasma glucose(FPG)level,hemoglobin A_(1C)(HbA_(1c)),homeostasis model evaluationinsulin resistance(HOMA-IR),blood lipid,uric acid,and urine albumin-to-creatinine ratio were measured in both groups,and the effects of dapagliflozin on the EAT thickness and serum omentin-1 level were analyzed.Results There was no statistically difference between the two groups at the time of enrollment(P>0.05).After 24 weeks of dapagliflozin treatment,the body weight,BMI,WC,systolic blood pressure,FPG,HbA_(1c),HOMA-IR,uric acid,urinary albumin-to-creatinine ratio,triglycerides(TG),total cholesterol(TC)level,and EAT thickness were significantly reduced compared with the pre-treatment measurements(P<0.05),while the serum omentin-1 and high density lipoprotein-cholesterol(HDL-C)levels were significantly increased(P<0.05).The post-treatment changes in the EAT thickness,serum omentin-1 level,and HDL-C level in the observation group were more significant than the corresponding post-treatment changes in the control group.Multiple linear regression showed that the serum omentin-1 level was an independent risk factor for the EAT thickness;the regression equation was as follows:Y_(EAT)=3.893-0.017×X_(omentin)-1+0.078×X_(HOMA-IR)+0.148×X_(LDL-C)+0.008×X_(WC)(R^(2)=0.789,F=42.46,P<0.05).Conclusions The serum omentin-1 level is an independent risk factor for the EAT thickness.Dapagliflozin is shown to increase the serum omentin-1 level in patients with T2DM and CAD and reduce insulin resistance,thereby reducing the EAT thickness and exerting a protective role in vascular disease.
作者
边守政
王国君
BIAN Shouzheng;WANG Guojun(Graduate School of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou,Neimenggu 014000,China;不详)
出处
《慢性病学杂志》
2023年第4期510-514,共5页
Chronic Pathematology Journal
关键词
达格列净
2型糖尿病
冠心病
网膜素1
心外膜脂肪
Dapagliflozin
Type 2 diabetes mellitus
Coronary artery disease
Omentin-1
Epicardial adipose tissue
