| Objective In recent years,with the improvement of living standards,the prevalence of type2 diabetes is gradually increasing.However,there is still no effective way to cure type 2diabetes.The main treatment is to control blood sugar.How to effectively control blood sugar is currently needed to be solved problem.Oral hypoglycemic drugs are an important method for controlling blood sugar.At present,there are many types of oral hypoglycemic drugs,including traditional insulin secretagogues,which have the effect of increasing body weight and easily causing hypoglycemia.The use of such hypoglycemic drugs for type 2Diabetic patients are at risk and are not conducive to their long-term glycemic control.In recent years,new oral hypoglycemic agents have gradually become widely recognized and widely used,including DPP-4 and SGLT-2 inhibitors.These drugs are used for glycemic control and serum related indicators and body weight in patients with type 2 diabetes.Cystatin c is an endogenous cysteine protease inhibitor that plays a role in aging,apoptosis,cell differentiation,proliferation and migration of some cell types.It is produced by all nucleated cells in the body,removed from the bloodstream by the glomerulus,and is considered a biomarker that reflects glomerular filtration rate more than creatinine.The SGLT-2 inhibitor mainly acts on the kidney,and it is proved that it has no damage to renal function by observing the serum cystatin c.Asprosin is a novel adipocytokines.It is mainly produced and secreted by white fat cells,which on the one hand can bind to receptors on the surface of hepatocytes,stimulate the glucose output of liver cells,and directly increase blood sugar.On the other hand,studies have shown that it can significantly improve glucose tolerance in mice and increase insulin sensitivity.There are no studies on the effects of DPP-4 inhibitors and SGLT-2 inhibitors on serum Asprosin.In this paper,the application of dapagliflozin and saxagliptin was used to measure the changes of serum cystatin C,asprosin,body weight and other related indicators before and after treatment in patients with type 2diabetes.Methods From January 2018 to December 2018,63 patients with type 2 diabetes mellitus who were admitted to the Department of Endocrinology and Hospitalization of the Affiliated Hospital of Qingdao University were randomly divided into 2 groups and treated with dapagliflozin group(n=31).Protocol: Based on the original hypoglycemic regimen,dapagliflozin 10 mg qd+ metformin 500 mg tid;saxagliptin group(n=32)treatment plan: the original hypoglycemic regimen based on saxagliptin 5mg qd + metformin 500 mg tid Follow-up for 12 weeks.At baseline and at 12 weeks of treatment,the patient’s waist circumference,blood pressure,body mass index(BMI),glycosylated hemoglobin(Hb A1c),biochemical indicators: blood lipids(TG,TC,HDL,LDL),uric acid(UA),creatinine(Cr)were observed.,Creatinine clearance,insulin related indicators: fasting insulin(FINS),fasting C peptide,steady state model IR index:(HOMA-IR),islet beta cell function index(HOMA-β)and serum cystatin C,white lipid Related indicators such as Asprosin.Results After 12 weeks of treatment,(1)weight,BMI,waist circumference,glycosylated hemoglobin,fasting blood glucose,2 hours postprandial blood glucose,fasting insulin,fasting C peptide,blood pressure,HOMA-β,HOMA-IR after treatment with dapagliflozin group decreased compared with before treatment(P<0.05).After treatment,the basal metabolic rate,triglyceride,cholesterol,HDL,LDL,uric acid,cystatin C,and e GFR were not significantly changed before treatment(P>0.05).(2)Body weight,BMI,basal metabolic rate,blood pressure,triglyceride,cholesterol,HDL,LDL,uric acid,creatinine,cystatin C,and e GFR were not significantly changed after treatment with saxagliptin group(P>0.05).After treatment,glycated hemoglobin,fasting blood glucose,postprandial blood glucose,fasting insulin,fasting C-peptide,HOMA-β,HOMA-IR decreased compared with before treatment(P<0.05).(3)After 12 weeks of treatment,the improvement of FPG,2h PG and Hb A 1C in the two groups was better than that before treatment,and the difference was statistically significant(P <0.05).(4)The improvement of FINS,HOMA-IR,C-peptide and HOMA-β after treatment was better than that before treatment(P<0.05).(5)Asprosin in dapagliflozin and saxagliptin group was lower than before administration(P <0.05).(6)Pearson correlation analysis before treatment showed FPG(r=0.436,P<0.05),2h PG(r=0.256,P<0.05),triglyceride(r=0.265,P<0.05),HOMA-IR(r=0.287,P<0.05)was positively correlated with Asprosin.Further,changes in Asprosin before and after administration as a dependent variable,BMI,Hb A1 c,FPG,2h PG,triglyceride,cholesterol,high-density lipoprotein,low-density lipoprotein,uric acid,fasting insulin,fasting C-peptide,HOMA-IR,HOMA The changes before and after β-drug were independent variables,and multiple stepwise linear regression analysis was performed.The results showed that fasting blood glucose was independently associated with Asprosin(β=0.637,P<0.05).Conclusion Dagliflozin has the effects of reducing body weight,lowering blood pressure,effectively lowering blood glucose level and lowering glycosylated hemoglobin,and improving insulin resistance,but has no significant effect on blood lipids,uric acid,creatinine,cystatin c and e GFR.Saxagliptin can effectively reduce glycated hemoglobin and improve insulin resistance,but has no significant effect on body weight and blood lipids.Significance This study was to observe changes in body weight,blood pressure,glycosylated hemoglobin,insulin resistance,and Asprosin before and after treatment.Analysis of the interaction between indicators and tube relationships,and found that glycosylated hemoglobin,fasting insulin,fasting C-peptide,HOMA-β,HOMA-IR were improved after treatment with dapagliflozin and saxagliptin group(P <0.05).Body weight and blood pressure were lower in the dapagliflozin group(P<0.05).It can guide the choice of clinical medications and provide ideas for other animal and clinical drug trials. |
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