达格列净附加治疗一年可改善2型糖尿病患者胰岛素抵抗和肥胖的替代指标。
One Year of Dapaglifozin Add-On Therapy Ameliorates Surrogate Indexes of Insulin Resistance and Adiposity in Patients with Type 2 Diabetes Mellitus.
作者信息
Radellini Stefano, Vigneri Enrica, Guarnotta Valentina, Panto Felicia, Giordano Carla
机构信息
Section of Endocrinology, Department of Health Promotion Sciences, Maternal-Infant Care, Internal Medicine and Specialties of Excellence "G. D'Alessandro" (PROMISE), University Hospital P. Giaccone, University of Palermo, Piazza Delle Cliniche 2, 90127, Palermo, Italy.
出版信息
Diabetes Ther. 2021 Jun;12(6):1677-1688. doi: 10.1007/s13300-021-01056-4. Epub 2021 Apr 30.
INTRODUCTION
This study investigates the effects of dapagliflozin on the visceral adiposity index (VAI), lipid accumulation product (LAP), product of triglycerides and glucose (TyG) and triglycerides to HDL-cholesterol ratio (TG/HDL-C) in patients with type 2 diabetes mellitus (T2D).
METHODS
In this real-life study, dapaglifozin was added to metformin alone (group 1, no. 42) or insulin plus metformin (group 2, no. 58) in 100 T2D patients.
RESULTS
In group 1, after 6 months of dapaglifozin addition, a significant decrease in BMI (p < 0.001), waist circumference (WC) (p < 0.001), systolic blood pressure (SBP) (p = 0.009), diastolic blood pressure (DBP) (p = 0.012), mean fasting blood glucose (FBG), post-breakfast glucose (PBG), post-lunch glucose (PLG) and post-dinner glucose (PDG) (all p < 0.001), HbA1c (p < 0.001), VAI (p = 0.020), LAP (p = 0.028), Tyg (p < 0.001), TG/HDL-C (p = 0.020) and glutamate pyruvate transaminase (GPT) (p < 0.001) was observed compared to baseline. After 12 months a significant decrease in BMI (p < 0.001), WC (p = 0.006), SBP (p = 0.023), DBP (p = 0.005), mean FPG, PBG, PLG and PDG (all p < 0.001), HbA1c (p < 0.001), total cholesterol (p = 0.038), triglycerides (p = 0.026), VAI (p = 0.013), GPT (p < 0.001), LAP index (p = 0.024), Tyg index (p < 0.001) and TG/HDL-c ratio (p = 0.016) was observed compared to baseline. In group 2, after 6 months of dapaglifozin addition, a significant decrease in BMI (p < 0.001), WC (p < 0.001), SBP (p = 0.015), DBP (p = 0.007), mean FPG, PBG, PLG and PDG (all p < 0.001), HbA1c (p < 0.001), VAI (p = 0.040), LAP (p = 0.047), Tyg (p < 0.001), TG/HDL-C (p = 0.048) and GPT (p < 0.001) was observed compared to baseline. By contrast, after 12 months a significant decrease in BMI (p < 0.001), WC (p < 0.001), SBP (p = 0.001), DBP (p = 0.002), mean FPG, PBG, PLG and PDG (all p < 0.001), HbA1c (p < 0.001), GPT (p < 0.001) and Tyg index (p = 0.003) was observed compared to baseline.
CONCLUSIONS
Dapagliflozin treatment significantly reduced surrogate indexes of insulin resistance and adiposity in patients with T2D.
引言
本研究调查了达格列净对2型糖尿病（T2D）患者内脏脂肪指数（VAI）、脂质蓄积产物（LAP）、甘油三酯与葡萄糖乘积（TyG）以及甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-C）的影响。
方法
在这项真实世界研究中，100例T2D患者单独使用二甲双胍（1组，42例）或胰岛素联合二甲双胍（2组，58例）的基础上加用达格列净。
结果
在1组中，加用达格列净6个月后，与基线相比，体重指数（BMI）（p<0.001）、腰围（WC）（p<0.001）、收缩压（SBP）（p=0.009）、舒张压（DBP）（p=0.012）、平均空腹血糖（FBG）、早餐后血糖（PBG）、午餐后血糖（PLG）和晚餐后血糖（PDG）（均p<0.001）、糖化血红蛋白（HbA1c）（p<0.001）、VAI（p=0.020）、LAP（p=0.028）、TyG（p<0.001）、TG/HDL-C（p=0.020）和谷丙转氨酶（GPT）（p<0.001）均显著降低。12个月后，与基线相比，BMI（p<0.001）、WC（p=0.006）、SBP（p=0.023）、DBP（p=0.005）、平均空腹血糖、早餐后血糖、午餐后血糖和晚餐后血糖（均p<0.001）、糖化血红蛋白（p<0.001）、总胆固醇（p=0.038）、甘油三酯（p=0.026）、VAI（p=0.013）、GPT（p<0.001）、LAP指数（p=0.024）、TyG指数（p<0.001）和TG/HDL-c比值（p=0.016）均显著降低。在2组中，加用达格列净6个月后，与基线相比，BMI（p<0.001）、WC（p<0.001）、SBP（p=0.015）、DBP（p=0.007）、平均空腹血糖、早餐后血糖、午餐后血糖和晚餐后血糖（均p<0.001）、糖化血红蛋白（p<0.001）、VAI（p=0.040）、LAP（p=0.047）、TyG（p<0.001）、TG/HDL-C（p=0.048）和GPT（p<0.001）均显著降低。相比之下，12个月后，与基线相比，BMI（p<0.001）、WC（p<0.001）、SBP（p=0.001）、DBP（p=0.002）、平均空腹血糖、早餐后血糖、午餐后血糖和晚餐后血糖（均p<0.001）、糖化血红蛋白（p<0.001）、GPT（p<0.
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