司美格鲁肽注射液治疗不同体质量指数2 型糖尿病对糖脂代谢和脂肪因子的影响
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刘乾弘
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凉山州第二人民医院，四川西昌，615000
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摘要：目的 探讨司美格鲁肽注射液对不同体质量指数（BMI）2 型糖尿病（T2DM）患者糖脂代谢指标及脂肪因子水平的影响，为临床个体化治疗提供依据。方法 选取 2022 年 1 月 —2023 年 6 月于本院内分泌科就诊的 T2DM 患者 120 例，根据 BMI 分为正常体质量组（BMI 18.5~23.9 kg/m2，n=30）、超重组（BMI 24.0~27.9 kg/m2，n=45）及肥胖组（BMI ≥ 28.0 kg/m2，n=45）。三组均给予司美格鲁肽注射液治疗（初始剂量 0.25 mg / 周，2 周后增至 0.5 mg / 周，持续治疗 12 周），同时维持基础降糖方案（二甲双胍单药或联合非胰岛素类降糖药）不变。比较治疗前、治疗 12 周后三组患者空腹血糖（FPG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）等糖脂代谢指标，以及血清瘦素（Leptin）、脂联素（Adiponectin）、抵抗素（Resistin）等脂肪因子水平，记录治疗期间不良反应发生情况。结果及结论 发现司美格鲁肽注射液可有效改善不同 BMI T2DM 患者的糖脂代谢紊乱，调节脂肪因子水平，且对肥胖及超重患者的糖脂代谢改善效果更显著，安全性良好，可作为 T2DM 患者个体化治疗的优选药物之一。
关健词：司美格鲁肽；2型糖尿病；体质量指数；糖脂代谢；脂肪因子
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Effects of Semaglutide Injection on Glucose and Lipid Metabolism and Adipokines in Type 2 Diabetes Patients with Different Body Mass Index
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Qianhong Liu
Liangshan Prefecture Second People’s Hospital，Xichang Sichuan ,615000 , China
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Abstract: Objective To investigate the effects of semaglutide injection on glucose and lipid metabolism indicators andadipokine levels in type 2 diabetes mellitus (T2DM) patients with different body mass index (BMI), providing evidence forindividualized clinical treatment. Methods A total of 120 T2DM patients treated in the Endocrinology Department of ourhospital from January 2022 to June 2023 were enrolled. Participants were stratified by BMI into the normal weight group (BMI18.5–23.9 kg/m2, n=30), overweight group (BMI 24.0–27.9 kg/m2, n=45), and obese group (BMI ≥28.0 kg/m2, n=45). All threegroups received semaglutide injection therapy (initial dose 0.25 mg/week, increased to 0.5 mg/week after 2 weeks, continuedfor 12 weeks) while maintaining their baseline hypoglycemic regimen (metformin monotherapy or combined with non-insulinhypoglycemic agents). Pre-treatment and 12-week post-treatment comparisons were conducted for fasting plasma glucose (FPG),glycated hemoglobin (HbA1c), fasting insulin (FINS), insulin resistance index (HOMA-IR), total cholesterol (TC), triglycerides(TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and other glucose and lipidmetabolism indicators. Levels of adipokines including serum leptin, adiponectin, and resistin were also measured. Adverseevents occurring during treatment were recorded. Results and Conclusions Semaglutide injection was found to effectivelyimprove glucose and lipid metabolism disorders in T2DM patients across different BMI ranges, regulate adipokine levels, anddemonstrate more pronounced metabolic improvements in obese and overweight patients. With good safety profiles, it may serveas a preferred option for individualized treatment in T2DM patients.
Keywords : Semaglutide; Type 2 diabetes; Body mass index; Glucose and lipid metabolism; Adipokines
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