达格列净对2型糖尿病患者脂肪和碳水化合物代谢的影响

S. Gogoleva, A. Ametov, A. Shabalina
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摘要

目的:探讨达格列净对2型糖尿病(T2DM)碳水化合物和脂肪代谢障碍的影响。设计:开放式队列对照前瞻性研究。材料和方法。本研究对60例T2DM合并肥胖患者进行了检查。在二甲双胍单药治疗中加入达格列净10mg。碳水化合物代谢和脂肪代谢指标评估6个月:人体测量、体成分分析、脂肪因子(脂联素、瘦素、鸢尾素、白细胞介素(IL) 6)评估和脂质面板。结果。添加达格列净导致糖化血红蛋白水平平均下降0.6% (p = 0.093),同时对脂肪代谢指标有显著的积极影响。平均体重下降3.3 kg (p < 0.05)。根据身体成分分析报告,脂肪量也显著减少3公斤(p = 0.001),肌肉量也显著增加,这与瘦素水平降低(p = 0.073)、脂联素和鸢尾素水平升高(p < 0.05)相关。总胆固醇、甘油三酯和低密度脂蛋白水平也显著下降(p = 0.001)。结论。瘦素和IL-6水平降低,鸢尾素和脂联素水平升高,与脂肪量减少和肌肉量增加相关,这与添加达格列净治疗发生的脂肪量减少和肌肉量增加有关。这些发现表明,代谢不健康的肥胖有可能转变为代谢健康的肥胖。脂肪组织功能障碍治疗作为治疗的重点,不仅可以更好地控制T2DM,而且可以降低心脏代谢风险。关键词:2型糖尿病,达格列净,脂联素,瘦素,鸢尾素,白细胞介素6,脂质面板,脂肪代谢
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of Dapagliflozin on Fat and Carbohydrate Metabolism in Patients with Type 2 Diabetes Mellitus
Aim: To determine the effects of dapagliflozin in impaired carbohydrate and fat metabolism in type 2 diabetes mellitus (T2DM). Design: An open cohort controlled prospective study. Materials and methods. In this study 60 patients with T2DM and obesity were examined. Dapagliflozin 10 mg was added to metformin monotherapy. Carbohydrate metabolism and fat metabolism markers were evaluated for 6 months: anthropometry, body composition analysis, assessment of adipokines (adiponectin, leptin, irisin, interleukin (IL) 6) and lipid panel. Results. Dapagliflozin addition resulted in glycated hemoglobin level decrease by an average of 0.6% (p = 0.093) along with significant positive effects on fat metabolism markers. The mean body mass decrease was 3.3 kg (p < 0.05). There was also a significant decrease in fat mass of 3 kg (p = 0.001) and a muscle mass extension, according to a body composition analysis report, which correlated with leptin levels decrease (p = 0.073) and adiponectin and irisin levels increase (p < 0.05). A significant decrease in total cholesterol, triglycerides and low-density lipoproteins levels also occurred (p = 0.001). Conclusion. Leptin and IL-6 levels decrease and irisin and adiponectin levels increase correlating with a fat mass reduction and muscle mass expansion occurred with dapagliflozin added to the therapy. These findings suggest the possibility of metabolically unhealthy obesity transitioning to metabolically healthy obesity. Adipose tissue dysfunction treatment as a focus of therapy may provide not only a better control of T2DM, but also cardiometabolic risks reduction. Keywords: type 2 diabetes mellitus, dapagliflozin, adiponectin, leptin, irisin, interleukin 6, lipid panel, fat metabolism.
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