实用肝脏病杂志2026，Vol.29Issue(3)：353-356,4.DOI:10.3969/j.issn.1672-5069.2026.03.009
达格列净联合二甲双胍治疗T2DM合并NAFLD患者糖脂代谢和自主神经功能变化研究
Improvement of autonomic nerve functions by dapagliflozin and metformin combination therapy in patients with T2DM and NAFLD
摘要
Abstract
Objective The aim of this study was to investigate dapagliflozin and metformin combination therapy in patients with type 2 diabetes mellitus(T2DM)and non-alcoholic fatty liver disease(NAFLD).Methods A total of 105 patients with T2DM and NAFLD were encountered in our hospital between March 2023 and March 2025,and were randomly assigned to receive metformin in 52 cases for control,or take oral dapagliflozin and metformin in 53 cases for 24 weeks.Serum fasting insulin(FINS)was detected by electrochemiluminescence,and homeostasis model assessment of insulin resistance(HOMA-IR)was calculated.The area of visceral fat was measured by visceral fat detector.The densities of liver and spleen were detected by CT scanner,and liver to spleen CT ratio was calculated.The heart rate variability indexes,e.g.,standard deviation of NN intervals(SDNN),standard deviation of the average NN intervals(SDANN),root mean square of successive differences(rMSSD),percent of NN50 in the total number of NN intervals(pNN50),low frequency(LF)and high frequency(HF)were monitored by 24 h electrocardiogram.Results By end of 24-week treatment,visceral fat area in combination group was(126.6±15.8)cm2,much less than[(135.8±17.0)cm2,P＜0.05],while liver/spleen CT ratio was(0.9±0.2),much greater than[(0.8±0.2)cm2,P＜0.05]in the control;HbA1c,FPG and HOMA-IR were(7.0±0.9)％,(6.0±0.8)mmol/L and(2.2±0.3),all significantly lower than[(7.7±1.0)％,(6.8±0.9)mmol/L and(2.7±0.3),respectively,P＜0.05]in the control;SDNN,SDANN,rMSSD,pNN50,LF and HF were(111.2±13.9)ms,(106.9±13.4)ms,(21.9±4.7)ms,(4.2±0.9)％,(801.5±100.2)ms2 and(494.8±91.9)ms2,all much higher than[(98.1±12.3)ms,(89.3±11.2)ms,(19.5±4.4)ms,(3.7±0.8)％,(724.9±90.6)ms2 and(415.6±82.0)ms2,respectively,P＜0.05]in the control group.Conclusion Combination of dapagliflozin and metformin in treatment of patients with T2DM and NAFLD could significantly improve glucose metabolism,reduce visceral fat,and improve autonomic nerve functions.关键词
非酒精性脂肪性肝病/2型糖尿病/达格列净/二甲双胍/自主神经功能/治疗Key words
Non-alcoholic fatty liver disease/Type 2 diabetes mellitus/Dapagliflozin/Metformin/Autonomic nerve functions/Therapy引用本文复制引用
安盟盟,张芳,李辉,刘建凤,张于,安向莲,关平..达格列净联合二甲双胍治疗T2DM合并NAFLD患者糖脂代谢和自主神经功能变化研究[J].实用肝脏病杂志,2026,29(3):353-356,4.基金项目
河北省医学科学研究计划项目(编号:20200296) （编号:20200296）
