Effect of dapagliflozin and metformin combined with liraglutide on visceral fat and renal function in patients with type 2 diabetic nephropathy
Objective To explore the effect of dapagliflozin and metformin in combination with liraglutide on visceral fat and renal function in patients with type 2 diabetic nephropathy.Methods A total of 159 patients with type 2 diabetic nephropathy treated in the First Affiliated Hospital of Ningbo University from December 2022 to December 2023 were retrospectively selected as the research subjects.After PSM matching,102 patients were included in this study and divided into the experimental group and the control group,with 51 patients in each group.The patients in the experimental group were treated with metformin and dapagliflozin combined with liraglutide while those in the control group were treated with metformin and dapagliflozin in combination.The patient's blood sugar indexes,blood lipid indexes,renal function indexes and the fat content of the heart,liver and kidney was determined before medication and 6 months after the end of the medication.Results The levels of FPG,2 hPG,HbAlc,TC,TG,LDL-C,and visceral fat area were all decreased after treatment,and they were(6.35±1.05)mmol·L-1,(7.43±1.36)mmol·L-1,(7.15±1.79)%,(4.15±1.18)mmol·L-1,(1.17±0.33)mmol·L-1,(2.75±0.53)mmol·L-1,and(74.12±5.43)cm2 in the experimental group,which were lower than those of(6.83±1.11)mmol·L-1,(9.58±1.47)mmol·L-1,(7.98±1.87)%,(4.68±1.23)mmol·L-1,(1.87±0.51)mmol·L-1,(3.27±0.64)mmol·L-1 and(79.66±6.81)cm2 in the control(t=2.243,7.667,2.290,2.220,8.229,4.469,4.542,all P<0.05).The serum levels of nitrogen(BUN),blood creatinine(Scr),β2-microglobulin(β2-MG)and urinary microalbumin to creatinine ratio(UACR)were all decreased after treatment,and they were(7.01±1.25)mmol·L-1,(52.12±8.81)μmol·L-1,(3.75±0.88)mg·L-1 and(25.57±2.86)mg·g-1 in the experimental group,which were lower than those of(7.53±1.28)mmol·L-1,(57.47±9.18)μmol·L-1,(4.95±1.58)mg·L-1 and(28.34±3.02)mg·g-1(t=2.076,3.003,4.738,4.756,all P<0.05).The level of high-density lipoprotein cholesterol(HDL-C)was increased in both groups after treatment and it was significantly higher in the experimental group than in the control((1.42±0.21)mmol·L-1 vs(1.29±0.16)mmol·L-1)(t=3.517,P<0.001).Adverse reaction such as hypoglycemia,rash,and gastrointestinal reactions occurred in both groups after treatment.Their occurring rates in the experimental group were 9.80%,7.84%,and 9.80%respectively,and they were 5.88%,7.84%,and 9.80%in the control.The difference was not statistically significant(χ2=0.136,0.136,0.111,P=0.713,0.713,0.739).Conclusion Treatment of patients with type 2 diabetic nephropathy by using dapagliflozin and metformin combined with liraglutide can significantly decrease the blood sugar and blood lipid levels and reduce visceral fat to result in reduction of kidney damage.
DapagliflozinMetforminLiraglutideType 2 diabetic nephropathyVisceral fatRenal function
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