Department of Endocrinology, The Third People Hospital of Huizhou, The Affiliated Hospital of Guangzhou Medical University, Huizhou, Guangdong, China (mainland).
Department of Urology, Citic Huizhou Hospital, Huizhou, Guangdong, China (mainland).
Med Sci Monit. 2020 Apr 2;26:e921891. doi: 10.12659/MSM.921891.
BACKGROUND The current study aimed to compare the effects of dapagliflozin and sitagliptin on insulin resistant and body fat distribution in newly diagnosed type 2 diabetic patients. MATERIAL AND METHODS This study was an open-label, parallel controlled study. Patients were included if they were newly diagnosed with type 2 diabetes (<6 months) and had been receiving dapagliflozin or sitagliptin for 12 weeks in combination with a stable dose of metformin in the last month. At baseline and 12 weeks, insulin resistant (homeostatic model assessment of insulin resistance [HOMA-IR]), body fat distribution (waist/hip ratio), fasting blood glucose (FBG), glycated hemoglobin A1c (HbA1c), lipid profiles, and C-reactive protein (CRP) level were compared. RESULTS There were 59 patients receiving dapagliflozin and 67 patients receiving sitagliptin. There was no significant between-group difference in baseline characteristics. After 12 weeks of treatment, compared to the sitagliptin group, the FBG (6.4±0.5 versus 6.7±0.7 mmol/L), HbA1c (7.0±0.4 versus 7.2±0.5%), HOMA-IR (1.6±0.5 versus 1.8±0.6), triglyceride (1.6±0.4 versus 1.8±0.3 mmol/L), and CRP (3.1±0.7 versus 3.3±0.5 mg/L) were slightly lower in the dapagliflozin group. Within each group, compared to baseline, FBG (dapagliflozin [6.4±0.5 versus 7.8±0.7 mmol/L]; sitagliptin [6.7±0.7 versus 7.7±0.6 mmol/L]), HbA1c (dapagliflozin [7.0±0.4 versus 8.0±0.5%]; sitagliptin [7.2±0.5 versus 8.1%±0.6%]), HOMA-IR (dapagliflozin [1.6±0.5 versus 2.4±0.4]; sitagliptin [1.8±0.6 versus 2.5±0.4]), triglyceride (dapagliflozin [1.6±0.4 versus 2.2±0.5 mmol/L]; sitagliptin [1.8±0.3 versus 2.1±0.5 mmol/L]), and CRP (dapagliflozin [3.1±0.7 versus 6.2±1.1 mg/L]; sitagliptin [3.3±0.5 versus 6.1±1.0 mg/L]) were significantly decreased. CONCLUSIONS Dapagliflozin and sitagliptin had comparable effects on improving insulin resistant and blood glucose control, and these benefits may be associated with improvement of systemic inflammation.
本研究旨在比较达格列净和西格列汀对新诊断 2 型糖尿病患者胰岛素抵抗和体脂分布的影响。
这是一项开放标签、平行对照研究。纳入标准为新诊断的 2 型糖尿病患者（<6 个月），且在过去 1 个月中，联合稳定剂量二甲双胍，接受达格列净或西格列汀治疗 12 周。在基线和 12 周时，比较胰岛素抵抗（稳态模型评估的胰岛素抵抗指数 [HOMA-IR]）、体脂分布（腰臀比）、空腹血糖（FBG）、糖化血红蛋白 A1c（HbA1c）、血脂谱和 C 反应蛋白（CRP）水平。
共纳入 59 例接受达格列净治疗的患者和 67 例接受西格列汀治疗的患者。两组患者的基线特征无显著差异。治疗 12 周后，与西格列汀组相比，达格列净组 FBG（6.4±0.5 与 6.7±0.7 mmol/L）、HbA1c（7.0±0.4 与 7.2±0.5%）、HOMA-IR（1.6±0.5 与 1.8±0.6）、三酰甘油（1.6±0.4 与 1.8±0.3 mmol/L）和 CRP（3.1±0.7 与 3.3±0.5 mg/L）水平略低。在每个治疗组中，与基线相比，FBG（达格列净组[6.4±0.5 与 7.8±0.7 mmol/L]；西格列汀组[6.7±0.7 与 7.7±0.6 mmol/L]）、HbA1c（达格列净组[7.0±0.4 与 8.0±0.5%]；西格列汀组[7.2±0.5 与 8.1%±0.6%]）、HOMA-IR（达格列净组[1.6±0.5 与 2.4±0.4]；西格列汀组[1.8±0.6 与 2.5±0.4]）、三酰甘油（达格列净组[1.6±0.4 与 2.2±0.5 mmol/L]；西格列汀组[1.8±0.3 与 2.1±0.5 mmol/L]）和 CRP（达格列净组[3.1±0.7 与 6.2±1.1 mg/L]；西格列汀组[3.3±0.5 与 6.1±1.0 mg/L]）均显著降低。
达格列净和西格列汀改善胰岛素抵抗和血糖控制的效果相当，这些益处可能与全身炎症的改善有关。
