陈纤纤,冯烈,梁健萍,卢筱华
CHEN Xianxian,FENG Lie,LIANG Jianping,LU Xiaohua

• 1:暨南大学附属第一医院内分泌与代谢科

摘要(Abstract)：

目的探讨二甲双胍及沙格列汀单用或联用对于非肥胖2型糖尿病(T2DM)患者体重、体脂含量变化的影响。方法按开放性、随机分组的设计将新诊断的非肥胖(BMI<24 kg/m2)T2DM患者分为二甲双胍单药治疗组7例,沙格列汀单药治疗组6例、沙格列汀联合二甲双胍治疗组8例,测定治疗前及治疗6个月后糖化血红蛋白(Hb A1C)、体重、腰围、臀围和血脂等指标,并用DEXA方法测定全身脂肪含量、腰腹部(A区)及臀部(G区)脂肪含量,并计算体重指数(BMI)、腰臀比、脂肪指数(FMI)、A区与G区脂肪比值并进行比较。结果非肥胖的T2DM患者治疗6个月后,无论是单用二甲双胍或沙格列汀,还是联合用药在体重、体内脂肪、血糖及血脂较治疗前均有明显的下降,差异有统计学意义。而联合用药组患者在全身及腰腹部脂肪组织含量的减少,腰臀比、FMI、Hb A1C及甘油三酯水平的下降方面均优于单用二甲双胍或沙格列汀的患者。结论对初诊非肥胖T2DM患者无论是单用二甲双胍或沙格列汀,还是联合用药都可有效控制血糖,减少体脂、降低血脂,也有减轻体重的作用,且联合用药在上述方面有更强的作用。通过DEXA评估全身及内脏脂肪可更敏感的反映糖尿病发生发展过程中体脂的变化情况。
OBJECTIVE To investigate the effect of metformin versus saxagliptin versus metformin combining with saxagliptin on body weight and adipose tissue content in non-obese patients with type 2 diabetes mellitus. METHODS The newly diagnosed nonobese( BMI < 24 kg / m2) patients with type 2 diabetes mellitus were randomly assigned to 3 groups,including metformin group( n = 7),saxagliptin group( n = 6),and metformin combined with saxagliptin group( n = 8). The patients of each group received 6-month oral hypoglycemic agents. The changes of 6-month treatment in following variables were recorded and compared. The variables were body weight,BMI,waist and hip circumference,glycosylated hemoglobin( Hb A1C),blood lipids( TC,TG,LDL-C) and the data measuring by DEXA. The data were including body fat,fat mass index( FMI),waist and hip fat content,waist abdomen and hip fat content ratio. RESULTS After the treatment for 6 months,the recorded various parameters of three groups in the non-obese patients with type 2 diabetes mellitus were significantly improved compared with pre-treatment. Hb A1 C,FMI,TG,body fat,waist fat and hip fat in patients treated with metformin and saxagliptin were significantly lower than those of the monotherapy groups. CONCLUSION The monotherapy of metformin or saxagliptin,and the combined therapy of metformin and saxagliptin can control the blood glucose and decrease the body fat and blood lipids,as well as reduce the body weigh of the non-obese patients with type 2 diabetes mellitus.Moreover the efficacy of the combined therapy was stronger. The assessment of the adipose tissue content using by DEXA more sensitively reflected the body fat change of the development of type 2 diabetes mellitus.

关键词(KeyWords)： 非肥胖2型糖尿病;二甲双胍;沙格列汀;体重;体脂含量
non-obese;type 2 diabetes mellitus;metformin;saxagliptin;body weight;body adipose tissue

Abstract:

Keywords:

基金项目(Foundation): 广东省药学会2型糖尿病用药研究基金(2012C03)

作者(Author): 陈纤纤,冯烈,梁健萍,卢筱华
CHEN Xianxian,FENG Lie,LIANG Jianping,LU Xiaohua

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