Analysis Of The Effect Of Dapagliflozin On The Glucose And Lipid Metabolism Indexes,Inflammatory Factors And Oxidative Stress In Diabetic Patients Based On The Level Of FGF21

ObjectiveTo study the changes in serum fibroblast growth factor 21(FGF21)and its association with glycolipid metabolism,inflammatory factors,and oxidative stress injury in patients with type 2 diabetes treated with dapagliflozin can help predict the development of diabetes and provide new directions for treatment.MethodsThe subjects were selected from the Department of Endocrinology of the hospital from March 2019 to March 2021,and 80 patients with type 2 diabetes mellitus were randomly divided into research group and control group,with 40 cases in each group.The control group was treated with oral metformin,and the study group was treated with oral metformin + dapagliflozin.To observe and compare glucose metabolism indexes [insulin resistance index(HOMA-IR),glycosylated hemoglobin(Hb A1c),fasting blood glucose(FBG),postprandial blood glucose(PBG),fasting insulin(FINS)],lipid metabolism indexes[cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL),apolipoprotein(Apo A-I,Apo B)],serum adipokines [serum adiponectin(APN),leptin],inflammatory factors levels [high mobility group box 1(HMGB-1),interleukin 6(IL-6),interleukin 8(IL-8),tumor necrosis factor alpha(TNF-α)],oxidative stress indicators [superoxide dismutase(SOD),malondialdehyde(MDA)] and FGF21 levels,and the correlation between FGF21 levels and other indicators was analyzed.Results1.General information: general information of patients from the two groups:there was no significant difference in gender,age,course of disease,BMI,and TC,TG,LDL,HDL,FBG,FINS,Hb A1 c,HOMA-IR,FGF-21 and other indicators before treatment between the two groups at baseline levels(P>0.05).2.Comparison of glucose metabolism between the two groups before and after treatment: before treatment,there was no significant difference in the levels of HOMA-IR,Hb A1 c,FBG,PBG and FINS between the two groups(P>0.05).After treatment,the levels of HOMA-IR,Hb A1 c,FBG,PBG,and FINS in the two groups were lower than those before treatment,and the levels of HOMA-IR,Hb A1 c,FBG,PBG,and FINS in the study group after treatment were significantly lower than those in the control group(P<0.05).3.Comparison of lipid metabolism between the two groups before and after treatment: before treatment,there was no significant difference in the levels of TG,HDL,VDL,TC,Apo A-I and Apo B between the two groups(P>0.05).After treatment,the levels of TG,TC and LDL in the two groups were lower than those before treatment,HDL was higher than before treatment,Apo A-I was higher than before treatment,and Apo B was lower than before treatment.There was a significant difference between the study group and the control group(P<0.05).4.Comparison of serum adipokines levels between the two groups before and after treatment: before treatment,there was no significant difference in serum adiponectin(APN)and leptin levels between the two groups(P>0.05).After treatment,serum adiponectin(APN)levels in the study group were significantly higher than those in the control group,and leptin levels decreased and were lower than those in the control group,and the difference was statistically significant(P<0.05).5.Comparison of inflammatory factor levels between the two groups before and after treatment: before treatment,there was no significant difference in the levels of HMGB-1,IL-6,TNF-α,IL-8 and other inflammatory factors between the two groups(P>0.05).After treatment,the levels of HMGB-1,IL-6,TNF-α and IL-8 in the two groups were lower than those before treatment,and the levels of HMGB-1,IL-6,TNF-α and IL-8 in the study group after treatment Significantly lower than the control group,the difference was statistically significant(P<0.05).6.Comparison of oxidative stress before and after treatment between the two groups: before treatment,there was no significant difference in malondialdehyde(MDA)and superoxide dismutase(SOD)between the two groups(P>0.05).After treatment,the content of malondialdehyde(MDA)in the study group was significantly lower than that in the control group,and there was a significant difference(P<0.05),and the level of superoxide dismutase(SOD)was significantly higher than that in the control group(P<0.05).7.Comparison of FGF21 levels between the two groups: before treatment,there was no difference in FGF21 levels between the two groups(P>0.05).After treatment,the levels of FGF21 in the two groups were lower than those before treatment,and the FGF21 levels in the study group were significantly lower than those in the control group after treatment,there was a difference(P<0.05).8.Correlation analysis: the result suggested that TG(r=0.540,P<0.05),LDL-C(r=0.416,P<0.05),FINS(r=0.381,P<0.05),HOMA-IR(r=0.929,P<0.05),TNF-α(r=0.552,P<0.05),IL-6(r=0.520,P<0.05),IL-8(r=0.756,P<0.05)were positively correlated with FGF21 levels.ConclusionsDapagliflozin reduced the hypermetabolic state and chronic inflammatory state of the body,relieved the resistance state of FGF21,and then promoted the exertion of FGF21,and finally achieved the improvement of glucose and lipid metabolism,inflammatory response and oxidative stress in patients with type 2diabetes.