中国合理用药探索2026，Vol.23Issue(6)：75-82,8.DOI:10.3969/j.issn.2096-3327.2026.06.012
达格列净联合二甲双胍对2型糖尿病合并肥胖症患者糖脂代谢、胰岛功能及炎症指标的影响
Effects of Dapagliflozin Combined with Metformin on Glucose and Lipid Metabolism,Islet Function,and Inflammatory Markers in Patients with Type 2 Diabetes Mellitus and Obesity
摘要
Abstract
Objective:To investigate the effects of dapagliflozin(Dap)combined with metformin(Met)on glucose and lipid metabolism,islet function,and inflammatory markers in patients with type 2 diabetes mellitus(T2DM)and obesity.Methods:A total of 102 patients with T2DM and obesity admitted to our hospital from June 2021 to July 2024 were prospectively enrolled and randomly assigned,using a random number table method,to a control group and an observation group,with 51 patients in each group.Both groups received basic non-drug treatment according to their symptoms.On this basis,the control group received metformin hydrochloride tablets,while the observation group received dapagliflozin tablets in addition to the control treatment.Both groups were treated for 3 months.Glucose and lipid metabolism markers[fasting plasma glucose(FPG),2-hour postprandial plasma glucose(2hPG),lipoprotein-associated phospholipase A2(Lp-PLA2),glycosylated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)],islet function-related markers[homeostasis model assessment of insulin resistance(HOMA-IR)and homeostasis model assessment of β-cell function(HOMA-β)],inflammatory markers[platelet-to-lymphocyte ratio(PLR)and neutrophil-to-lymphocyte ratio(NLR)],clinical efficacy,and treatment safety were compared between the two groups.Results:After 3 months of treatment,FPG,2hPG,Lp-PLA2,HbA1c,TC,TG,LDL-C,HOMA-IR,PLR,and NLR decreased in both groups and were lower in the observation group than in the control group(P<0.05).HDL-C and HOMA-β increased in both groups and were higher in the observation group than in the control group(P<0.05).The total effective rate of treatment was higher in the observation group than in the control group(96.08%vs 80.39%,P<0.05).There was no significant difference in the overall incidence of adverse reactions between the two groups(P>0.05).Conclusion:Dap combined with Met has definite efficacy in patients with T2DM and obesity.It can effectively regulate glucose and lipid metabolism,improve insulin resistance,reduce the inflammatory markers NLR and PLR,and improve islet function without increasing the risk of adverse reactions.关键词
达格列净/二甲双胍/2型糖尿病/肥胖症/胰岛素抵抗指数/中性粒细胞与淋巴细胞比值/血小板计数与淋巴细胞比值Key words
dapagliflozin/metformin/type 2 diabetes mellitus/obesity/homeostasis model assessment of insulin resistance/neutrophil-to-lymphocyte ratio/platelet-to-lymphocyte ratio分类
医药卫生引用本文复制引用
王莉莉,魏伟,齐小峰..达格列净联合二甲双胍对2型糖尿病合并肥胖症患者糖脂代谢、胰岛功能及炎症指标的影响[J].中国合理用药探索,2026,23(6):75-82,8.基金项目
河南省医学科技攻关计划项目(LHGJ20211097) （LHGJ20211097）
