2022 年第 12 期 第 17 卷

司美格鲁肽对2型糖尿病患者心血管危险因素的影响

Effect of semaglutide on cardiovascular risk factors in patients with type 2 diabetes mellitus

作者：张凤丽1张东凤2赵一楠1李宇2文丽娜1陶红1

英文作者：Zhang Fengli1 Zhang Dongfeng2 Zhao Yinan1 Li Yu2 Wen Lina1 Tao Hong1

单位：1首都医科大学附属北京安贞医院内分泌代谢科，北京100029;2首都医科大学附属北京安贞医院心血管内科，北京100029

英文单位：1Department of Endocrinology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Department of Cardiovascular Medicine Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：2型糖尿病；司美格鲁肽；非高密度脂蛋白胆固醇

英文关键词：Type2diabetesmellitus;Semaglutide;Non-high-densitylipoproteincholesterol

• 摘要：

• 目的  评估司美格鲁肽对2型糖尿病（T2DM）患者心血管危险因素的影响。方法  回顾性选取首都医科大学附属北京安贞医院内分泌代谢科2022年2月1—28日门诊就诊并接受司美格鲁肽治疗的T2DM患者作为研究对象。治疗前及治疗16周后，收集患者体质量、体重指数、糖化血红蛋白（HbA1c）、空腹血糖、收缩压、舒张压、脂质谱水平。患者门诊或者通过电话访视填写糖尿病治疗满意度问卷（DTSQ）并记录不良反应发生情况。结果  本研究共纳入475例T2DM患者。治疗后，患者体质量、体重指数、HbA1c、空腹血糖、收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇、三酰甘油、非高密度脂蛋白胆固醇水平均低于治疗前［（83±20）kg比（86±22）kg、（28±6）kg/m2比（30±8）kg/m2、（7.1±2.8）%比（8.4±1.3）%、（7.3±1.8）mmol/L比（10.4±2.1）mmol/L、（134±31）mmHg（1 mmHg=0.133 kPa）比（137±32）mmHg、（76±21）mmHg比（79±16）mmHg、（5.2±2.7）mmol/L比（5.4±2.5）mmol/L、（2.6±0.5）mmol/L比（3.1±1.1）mmol/L、（1.7±0.6）mmol/L比（2.4±0.7）mmol/L、（3.4±0.8）mmol/L比（3.6±0.8）mmol/L］，高密度脂蛋白胆固醇水平高于治疗前，差异均有统计学意义（均P＜0.01）。治疗16周时DTSQ中位评分为32.5分。治疗期间共71例(14.9%)患者出现不良反应，包括恶心58例(12.2%)、腹胀13例(2.7%)。不良反应症状轻微，随治疗时间延长逐渐减弱。结论  司美格鲁肽可以改善T2DM患者的代谢控制和血压、非高密度脂蛋白胆固醇水平等多重心血管危险因素。

• Objective  To evaluate the effect of semaglutide on cardiovascular risk factors in patients with type 2 diabetes mellitus (T2DM). Methods  From February 1 to 28, 2022, patients with T2DM and treated with semaglutide were selected from the Outpatient Clinic of Department of Endocrinology, Beijing Anzhen Hospital, Capital Medical University. Levels of body mass, body mass index, glycosylated hemoglobin (HbA1c), fasting blood glucose, systolic blood pressure, diastolic blood pressure, and lipid profile were recorded before and 16 weeks after treatment. Patients filled in diabetes treatment satisfaction questionnaire (DTSQ) in the outpatient department or through telephone visits, and adverse reactions were recorded. Results  Totally 475 patients were enrolled in this study. After treatment, levels of body mass, body mass index, HbA1c, fasting blood glucose, systolic blood pressure, diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triacylglycerol, and non-high-density lipoprotein cholesterol decreased［（83±20）kg vs （86±22）kg,（28±6）kg/m2 vs （30±8）kg/m2,（7.1±2.8）% vs （8.4±1.3）%,（7.3±1.8）mmol/L vs （10.4±2.1）mmol/L,（134±31）mmHg vs （137±32）mmHg,（76±21）mmHg vs （79±16）mmHg,（5.2±2.7）mmol/L vs （5.4±2.5）mmol/L,（2.6±0.5）mmol/L vs （3.1±1.1）mmol/L,（1.7±0.6）mmol/L vs （2.4±0.7）mmol/L,（3.4±0.8）mmol/L vs （3.6±0.8）mmol/L］, and the level of high-density lipoprotein cholesterol increased (all P<0.01). Median DTSQ score was 32.5 at the 16th week of treatment. There were 71 cases (14.9%) reported adverse reactions during treatment, including 58 cases (12.2%) of nausea and 13 cases (2.7%) of abdominal distention. The symptoms of adverse reactions were mild and gradually improved with the prolongation of treatment. Conclusion  Semaglutide can improve metabolic control, blood pressure and non-high-density lipoprotein cholesterol levels in patients with T2DM.