二甲双胍单药治疗以及二甲双胍联合双药或三药治疗对2型糖尿病患者血糖控制和血脂管理的影响。

Effect of metformin monotherapy and dual or triple concomitant therapy with metformin on glycemic control and lipid profile management of patients with type 2 diabetes mellitus.

作者信息

Lin Yan-Yu, Weng Shuen-Fu, Hsu Chung-Huei, Huang Chen-Ling, Lin Yu-Pei, Yeh Min-Chun, Han A-Young, Hsieh Yu-Shan

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei City, Taiwan.

Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.

出版信息

Front Med (Lausanne). 2022 Oct 14;9:995944. doi: 10.3389/fmed.2022.995944. eCollection 2022.

DOI:10.3389/fmed.2022.995944

PMID:36314019

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9614085/

Abstract

BACKGROUND

In this study, we aimed to compare the effects of metformin-based dual therapy versus triple therapy on glycemic control and lipid profile changes in Taiwanese patients with type 2 diabetes mellitus (T2DM).

METHODS

In total, 60 patients were eligible for participation in this study. Patients received at least 24 months of metformin monotherapy, dual therapy, or triple therapy with metformin plus linagliptin (a dipeptidyl peptidase 4 (DPP-4) inhibitor) or dapagliflozin (a sodium-glucose cotransporter-2 (SGLT2) inhibitor). Blood samples were collected from each patient, followed by evaluation of changes in their blood glucose control and lipid profile-related markers.

RESULTS

A combination of metformin and DPP4 and SGLT2 inhibitor therapy more effectively reduced low-density lipoprotein cholesterol (LDL-C) ( = 0.016) than metformin monotherapy. A combination of metformin and DPP4 and SGLT2 inhibitor therapy more effectively improved total cholesterol (Chol, = 0.049) and high-density lipoprotein cholesterol (HDL-C) than metformin monotherapy ( = 0.037). Metformin plus linagliptin dual therapy was more effective than metformin monotherapy in reducing glycosylated hemoglobin (HbA1C, = 0.011). Patients who received a combination of linagliptin and empagliflozin showed a significant reduction in their fasting blood glucose ( = 0.019), HbA1c ( = 0.036), and Chol ( = 0.010) compared with those who received linagliptin dual therapy. Furthermore, patients who received metformin plus dapagliflozin and saxagliptin showed significantly reduced Chol ( = 0.011) and LDL-C ( = 0.035) levels compared with those who received metformin plus dapagliflozin.

CONCLUSION

In conclusion, dual therapy with metformin and linagliptin yields similar glycemic control ability to triple therapy. Among metformin combination triple therapy, triple therapy of empagliflozin and linagliptin might have a better glycemic control ability than dual therapy of linagliptin. Moreover, Triple therapy of dapagliflozin and saxagliptin might have a better lipid control ability than dual therapy of dapagliflozin.

摘要

背景

在本研究中，我们旨在比较二甲双胍基础上的双联疗法与三联疗法对台湾2型糖尿病（T2DM）患者血糖控制和血脂谱变化的影响。

方法

共有60例患者符合参与本研究的条件。患者接受了至少24个月的二甲双胍单药治疗、双联疗法或三联疗法，三联疗法为二甲双胍联合利格列汀（一种二肽基肽酶4（DPP-4）抑制剂）或达格列净（一种钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂）。从每位患者采集血样，随后评估其血糖控制和血脂谱相关标志物的变化。

结果

与二甲双胍单药治疗相比，二甲双胍联合DPP4和SGLT2抑制剂疗法能更有效地降低低密度脂蛋白胆固醇（LDL-C）（P = 0.016）。与二甲双胍单药治疗相比，二甲双胍联合DPP4和SGLT2抑制剂疗法能更有效地改善总胆固醇（Chol，P = 0.049）和高密度脂蛋白胆固醇（HDL-C）（P = 0.037）。二甲双胍加利格列汀双联疗法在降低糖化血红蛋白（HbA1C，P = 0.011）方面比二甲双胍单药治疗更有效。与接受利格列汀双联疗法的患者相比，接受利格列汀和恩格列净联合治疗的患者空腹血糖（P = 0.019）、HbA1c（P = 0.036）和Chol（P = 0.010）显著降低。此外，与接受二甲双胍加达格列净的患者相比，接受二甲双胍加达格列净和沙格列汀的患者Chol（P = 0.011）和LDL-C（P = 0.035）水平显著降低。