卡格列净和恩格列净对肥胖2型糖尿病患者的临床疗效

doi:10.11958/20252351

摘要/Abstract

摘要：

目的分析卡格列净和恩格列净对肥胖2型糖尿病（T2DM）患者炎症指标、糖脂代谢及miR-144表达的影响。方法选取本院2021年6月—2024年5月收治的148例肥胖T2DM患者，采用随机数字表法将其均分为卡格列净组和恩格列净组。2组分别在常规治疗的基础上给予卡格列净、恩格列净治疗，均为6个月。比较2组患者炎症指标、糖代谢指标、脂代谢指标、微小核糖核酸-144（miR-144）表达、体质量指数（BMI）、临床疗效以及不良反应发生率。结果治疗期间共剔除7例后，卡格列净组为71例，恩格列净组为70例。治疗后，2组患者肿瘤坏死因子-α、白细胞介素-6、C反应蛋白、空腹血糖（FBG）、餐后2 h血糖（2 h-PPG）、糖化血红蛋白（HbA1c）、甘油三酯（TG）、总胆固醇、低密度脂蛋白胆固醇、BMI、miR-144表达均较治疗前降低（P<0.05），且卡格列净组FBG、2 h-PPG、HbA1c、TG、miR-144表达低于恩格列净组（P<0.05）。治疗后2组高密度脂蛋白胆固醇均较治疗前升高（P<0.05），且卡格列净组高于恩格列净组（P<0.05）。2组治疗后临床疗效、不良反应发生率比较差异无统计学意义（P>0.05）。结论卡格列净、恩格列净对肥胖T2DM患者均有一定疗效和良好安全性，卡格列净改善糖脂代谢效果更佳。

关键词: 糖尿病，2型, 肥胖症, 微RNAs, 卡格列净, 恩格列净

Abstract:

Objective To analyze effects of caragliflozin and empagliflozin on inflammatory markers, glucose and lipid metabolism and miR-144 expression in obese patients with type 2 diabetes mellitus (T2DM). Methods A total of 148 obese T2DM patients admitted to our hospital from June 2021 to May 2024 were selected and divided into the caragliflozin group and the empagliflozin group by random number table method. The two groups were treated with canagliflozin and empagliflozin on the basis of conventional treatment for 6 months. The inflammatory indicators, glucose metabolism indicators, lipid metabolism indicators, microRNA-144 (miR-144) expression, body mass index (BMI), clinical efficacy and incidence of adverse reactions were compared between the two groups. Results After a total of 7 cases were excluded during the treatment period, there were 71 cases in the caragliflozin group and 70 cases in the empagliflozin group. After treatment, the levels of tumor necrosis factor-α, interleukin-6, C-reactive protein, fasting blood glucose (FBG), 2 h postprandial blood glucose (2 h-PPG), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol, low density lipoprotein cholesterol, BMI and miR-144 expression were lower than those before treatment in two groups of patients (P<0.05), and the levels of FBG, 2 h-PPG, HbA1c, TG and miR-144 expression were lower in the caragliflozin group than those of the empagliflozin group (P<0.05). After treatment, high density lipoprotein cholesterol was higher than that before treatment in the two groups (P<0.05), and that in the canagliflozin group was higher than the empagliflozin group (P<0.05). There were no significant differences in the clinical efficacy and incidence of adverse reactions between the two groups after treatment (P>0.05). Conclusion Both caragliflozin and empagliflozin have certain therapeutic efficacy and good safety for obese T2DM patients, and caragliflozin is more effective in improving glucose and lipid metabolism.

Key words: diabetes mellitus, type 2, obesity, microRNAs, canagliflozin, empagliflozin

中图分类号:

R587.1

图/表 7

参考文献 22

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组别	n	性别		年龄/岁	病程/年	吸烟史	饮酒史	高脂血症	高血压史
组别	n	男	女	年龄/岁	病程/年	吸烟史	饮酒史	高脂血症	高血压史
卡格列净组	71	39（54.93）	32（45.07）	48.94±8.69	3.15±0.84	24（33.80）	18（25.35）	15（21.13）	20（28.17）
恩格列净组	70	37（52.86）	33（47.14）	48.29±8.91	3.26±0.76	19（27.14）	14（20.00）	11（15.71）	15（21.43）
χ²或t		0.061		0.450	0.769	0.738	0.576	0.687	0.858

组别	n	性别		年龄/岁	病程/年	吸烟史	饮酒史	高脂血症	高血压史
组别	n	男	女	年龄/岁	病程/年	吸烟史	饮酒史	高脂血症	高血压史
卡格列净组	71	39（54.93）	32（45.07）	48.94±8.69	3.15±0.84	24（33.80）	18（25.35）	15（21.13）	20（28.17）
恩格列净组	70	37（52.86）	33（47.14）	48.29±8.91	3.26±0.76	19（27.14）	14（20.00）	11（15.71）	15（21.43）
χ²或t		0.061		0.450	0.769	0.738	0.576	0.687	0.858

组别	n	TNF-α/（ng/L）			IL-6/（ng/L）			CRP/（mg/L）
组别	n	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
卡格列净组	71	23.68±3.17	16.23±2.30	16.472^＊＊	21.06±3.65	13.15±3.06	14.904^＊＊	3.76±0.97	2.03±0.87	10.845^＊＊
恩格列净组	70	24.12±3.39	16.82±2.67	14.275^＊＊	20.95±3.76	13.71±3.24	12.551^＊＊	3.68±0.84	2.18±0.91	10.145^＊＊
t		0.814	1.427		0.176	1.075		0.459	1.007

组别	n	TNF-α/（ng/L）			IL-6/（ng/L）			CRP/（mg/L）
组别	n	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
卡格列净组	71	23.68±3.17	16.23±2.30	16.472^＊＊	21.06±3.65	13.15±3.06	14.904^＊＊	3.76±0.97	2.03±0.87	10.845^＊＊
恩格列净组	70	24.12±3.39	16.82±2.67	14.275^＊＊	20.95±3.76	13.71±3.24	12.551^＊＊	3.68±0.84	2.18±0.91	10.145^＊＊
t		0.814	1.427		0.176	1.075		0.459	1.007

组别	n	FBG/（mmol/L）			2 h-PPG/（mmol/L）			HbA1c/%
组别	n	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
卡格列净组	71	10.56±1.23	6.16±0.91	25.430^＊＊	18.31±4.81	10.43±3.04	13.911^＊＊	9.12±0.75	6.96±0.67	17.322^＊＊
恩格列净组	70	10.41±1.17	6.53±0.97	20.460^＊＊	18.16±4.37	11.65±3.61	9.042^＊＊	9.06±0.84	7.23±0.78	12.366^＊＊
t		0.741	2.327^＊		0.211	2.169^＊		0.448	2.204^＊