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中华肥胖与代谢病电子杂志 ›› 2023, Vol. 09 ›› Issue (03) : 192 -196. doi: 10.3877/cma.j.issn.2095-9605.2023.03.008

论著

司美格鲁肽对肥胖2型糖尿病患者皮肤微循环功能的影响
李锦亮, 曾茂娟, 钟金宝, 何伟强, 林文新()   
  1. 510000 广州市,广州市皮肤病防治所中医科
    广州市皮肤病防治所药剂科
  • 收稿日期:2023-06-29 出版日期:2023-08-30
  • 通信作者: 林文新

Effect of semaglutide on skin microcirculatory function in obese patients with type 2 diabetes mellitus

Jinliang Li, Maojuan Zeng, Jinbao Zhong, Weiqiang He, Wenxin Lin()   

  1. Department of Traditional Chinese Medicine, Guangzhou Institute of Dermatology and Prevention, Guangzhou, 510000
    Department of Pharmacy, Guangzhou Institute of Dermatology and Prevention, Guangzhou, 510000
  • Received:2023-06-29 Published:2023-08-30
  • Corresponding author: Wenxin Lin
引用本文:

李锦亮, 曾茂娟, 钟金宝, 何伟强, 林文新. 司美格鲁肽对肥胖2型糖尿病患者皮肤微循环功能的影响[J/OL]. 中华肥胖与代谢病电子杂志, 2023, 09(03): 192-196.

Jinliang Li, Maojuan Zeng, Jinbao Zhong, Weiqiang He, Wenxin Lin. Effect of semaglutide on skin microcirculatory function in obese patients with type 2 diabetes mellitus[J/OL]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2023, 09(03): 192-196.

目的

探讨司美格鲁肽对肥胖2型糖尿病(T2DM)患者的皮肤微循环功能的影响。

方法

回顾性分析2022年6月至2023年1月诊断为2型糖尿病且合并肥胖,并于广州市皮肤病防治所门诊就诊的患者共94例,根据是否使用司美格鲁肽控制血糖分为观察组和对照组,其中使用司美格鲁肽联合二甲双胍控制血糖的(观察组)共44例,采用二甲双胍控制血糖的共50例(对照组),对比两组患者的BMI、血脂、血糖相关代谢指标的水平,用激光多普勒血流检测仪对两组患者在干预前和干预后3个月腹部脐周皮肤微循环功能进行检测。

结果

在干预3个月后,观察组的空腹血糖(FPG)、餐后2 h血糖(2hPG)、BMI值和糖化血红蛋白(HbAlc)水平均低于对照组,而C肽水平显著高于对照组(P<0.05);观察组在的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)水平均低于对照组,差异有统计学意义;而HDL-C水平显著高于对照组(P<0.05)。观察组的血细胞平均运动速度(AVBC)、运动血细胞浓度(CMBC)、微血管血流灌注量(MBP)和经皮氧分压(TcpO2)水平显著高于对照组(P<0.05)。

结论

司美格鲁肽不仅能改善肥胖2型糖尿病患者的糖脂代谢,也能改善患者的皮肤微循环状态。

Objective

To investigate the effect of semaglutide on skin microcirculation function in obese patients with type 2 diabetes mellitus.

Methods

A total of 94 patients with obesity diagnosed with type 2 diabetes mellitus from June 2022 to January 2023 were retrospectively analyzed in Guangzhou Institute of Dermatology and Prevention. According to whether or not to control blood sugar with smeagoutide, they were divided into observation group and control group, in which 44 patients were treated with smeagoutide combined with metformin, and 50 patients were treated with metformin. The levels of body mass index (BMI), blood lipid and blood glucose-related metabolic indexes of the two groups were compared, and the blood glucose was measured by laser Doppler blood flow detector (LDF).

Results

After three months of intervention, FPG, 2hPG, BMI and HbAlc levels in the observation group were lower than those in the control group, while the level of C peptide was significantly higher than that in the control group (P<0.05). The levels of total cholesterol (TC), triglyceride (TG) and low density lipoprotein (LDL-C) in the observation group were significantly lower than those in the control group, while the level of HDL-C was significantly higher than that in the control group (P<0.05). The average blood cell velocity (AVBC), exercise blood cell concentration (CMBC), microvascular blood perfusion (MBP) and percutaneous oxygen partial pressure (TcpO2) in the observation group were significantly higher than those in the control group (P<0.05).

Conclusions

Semaglutide can not only improve the glucose and lipid metabolism of obese patients with type 2 diabetes mellitus, but also improve the skin microcirculation.

表1 两组患者的一般资料对比
表2 两组患者治疗前后BMI、血糖、C肽以及HbAlc水平对比
表3 两组患者治疗前后TC、TG、LDL-C以及HDL-C水平对比
表4 两组患者治疗前后AVBC、CMBC、MBP以及TcpO2水平对比
[1]
王晓红, 赵天旺, 雷朝秋, 等. 中国1993—2015年儿童青少年腰围及腹型肥胖流行趋势 [J]. 中国学校卫生, 2020, 41(06): 897-900.
[2]
Graupera M, Claret M. Endothelial Cells: New Players in Obesity and Related Metabolic Disorders [J]. Trends Endocrinol Metab, 2018, 29(11): 781-794.
[3]
于莉莉, 李艳花, 张朝阳, 等. 不同组织慢性炎症的特点及其在胰岛素抵抗发展中的作用 [J/CD]. 中华肥胖与代谢病电子杂志, 2021, 7(04): 260-265.
[4]
Matsumura Y, Wei FY, Sakai J. Epitranscriptomics in metabolic disease [J]. Nat Metab, 2023, 5(3): 370-384.
[5]
肖哲, 周术锋, 朱欢, 等. 肥胖人群微血管反应性的变化及运动干预 [J]. 中国组织工程研究, 2023, 27(26): 4223-4230.
[6]
纪立农, 邹大进, 洪天配, 等. GLP-1受体激动剂临床应用专家指导意见 [J]. 中国糖尿病杂志, 2018, 26(05): 353-361.
[7]
孙倩, 谭伟. 司美格鲁肽治疗肥胖型2型糖尿病的研究进展 [J]. 中国现代医生, 2022, 60(29): 117-120.
[8]
王海旭, 巩秋红. 司美格鲁肽口服制剂治疗2型糖尿病的研究进展[J]. 中国糖尿病杂志, 2022, 30(11): 870-872
[9]
Sukumaran V, Tsuchimochi H, Sonobe T, et al. Liraglutide treatment improves the coronary microcirculation in insulin resistant Zucker obese rats on a high salt diet [J]. Cardiovasc Diabetol, 2020, 19(1): 24.
[10]
中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2017年版) [J]. 中国实用内科杂志, 2018, 38(04): 292-344.
[11]
陈婷, 邓斌, 廖占林. 司美格鲁肽联合二甲双胍治疗初诊2型糖尿病合并非酒精性脂肪肝的疗效分析 [J]. 糖尿病新世界, 2022, 25(21): 81-84.
[12]
朱欢, 胡庆华, 彭爱萍, 等. 长期太极拳运动对中老年人膝关节皮肤微血管反应性、经皮氧分压的影响 [J]. 中国应用生理学杂志, 2020, 36(04): 321-323+384.
[13]
Ryan DH, Lingvay I, Colhoun HM, et al. Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity (SELECT) rationale and design [J]. Am Heart J, 2020, 229: 61-69.
[14]
Jensen DM, Skovsted GF, Bonde MFB, et al. Semaglutide treatment attenuates vessel remodelling in ApoE-/- mice following vascular injury and blood flow perturbation [J]. Atheroscler Plus, 2022, 49: 32-41.
[15]
Donghui T, Shuang B, Xulong L, et al. Improvement of microvascular endothelial dysfunction induced by exercise and diet is associated with microRNA-126 in obese adolescents [J]. Microvasc Res, 2019, 123: 86-91.
[16]
Yue L, Chen S, Ren Q, et al. Effects of semaglutide on vascular structure and proteomics in high-fat diet-induced obese mice [J]. Front Endocrinol (Lausanne), 2022, 13: 995007.
[17]
Weghuber D, Barrett T, Barrientos-Pérez M, et al. Once-Weekly Semaglutide in Adolescents with Obesity [J]. N Engl J Med, 2022, 387(24): 2245-2257.
[18]
La Favor JD, Dubis GS, Yan H, et al. Microvascular Endothelial Dysfunction in Sedentary, Obese Humans Is Mediated by NADPH Oxidase: Influence of Exercise Training [J]. Arterioscler Thromb Vasc Biol, 2016, 36(12): 2412-2420.
[19]
Bovolini A, Costa-Brito AR, Martins F, et al. Impact of Exercise on Vascular Function in Middle-Aged and Older Adults: A Scoping Review [J]. Sports (Basel), 2022, 10(12).
[20]
Simó R, Bogdanov P, Ramos H, et al. Effects of the Topical Administration of Semaglutide on Retinal Neuroinflammation and Vascular Leakage in Experimental Diabetes [J]. Biomedicines, 2021, 9(8):926
[21]
Cha AS, Chen Y, Fazioli K, et al. Microvascular Benefits of New Antidiabetic Agents: A Systematic Review and Network Meta-Analysis of Kidney Outcomes [J]. J Clin Endocrinol Metab, 2021, 106(4): 1225-1234.
[22]
Goldney J, Sargeant JA, Davies MJ. Incretins and microvascular complications of diabetes: neuropathy, nephropathy, retinopathy and microangiopathy [J]. Diabetologia, 2023, 66(10): 1832-1845.
[23]
Jensen JK, Binderup T, Grandjean CE, et al. Semaglutide reduces vascular inflammation investigated by PET in a rabbit model of advanced atherosclerosis [J]. Atherosclerosis, 2022, 352: 88-95.
[24]
Mooradian AD. Evidence-Based Cardiovascular Risk Management in Diabetes [J]. Am J Cardiovasc Drugs, 2019, 19(5): 439-448.
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