Therapeutic Effect Of Sitagliptin Combined With Metformin On Overweight Patients With Type 2 Diabetes Mellitus And The Effect Of Chemerin Level

Objective:Chemerin is a newly discovered adipokine,which is related to metabolic syndrome,dyslipidrmia,insulin resistance.Sitagliptin is one of the most widely used DPP-4 inhibitors in the world.This study explores the effect of sitagliptin combined with metformin in the treatment of type 2 diabetic overweight,and to explore the effect of combination therapy on serum chemerin level.Methods:Thirty-nine patients,who were diagnosed as T2 DM and overweight in The First Affiliated Hospital of Xinjiang Medical University from March 2018 to August 2018,were enrolled in this study.They were divided into two groups,18 patients in sitagliptin combined with metformin group(9 males/9 females)andtwenty-one patients in metformin monotherapy group(14 males/7 females).Blood pressure,HbA1 c,FPG,FINS,ALT,AST,TG,TC,LDL-C,total bilirubin,creatinine and other biochemical indicators were collected before and after treatment for 12 weeks.,homeostasis model calculation of insulin resistance index(HOMA-IR),calculated body mass index(BMI),waist to hip ratio according to waist circumference and abdominal circumference,using enzyme-linked immunosorbent assay(ELISA)to determine serum chemerin levels.Results:(1)In experimental group,the waist-hip ratio,BMI,FPG,HbA1 c,SBP,DBP,HOMA-IR,TG,TC and LDL-C decreased significantly after intervention compared with before intervention(P < 0.05).There was no significant difference in insulin,total bilirubin,ALT,AST,creatinine and chemerin before and after intervention.(2)There was no significant difference in HbA1 c and FPG between the two groups before treatment(P > O.05).After treatment,FPG decreased significantly in both group.After treatment,FPG,TG,TC and LDL-C in the sitagliptin combined with metformin group were lower than those in the metformin group,and the difference was statistically significant(P< 0.05).There were no significant differences in waist-hip ratio,BMI,HbA1 c,SBP,DBP,HOMA-IR,insulin,total bilirubin,ALT,AST,creatinine and chemerin between the two groups.Conclusion: 1.The hypoglycemic effect of sitagliptin combined with Metformin in overweight patients with type 2 diabetes is not inferior to that of Metformin alone,but there is no significant difference in weight loss than metformin alone.2.It is not evident that sitagliptin combined with metformin has an effect on chemerin levels in overweight patients with type 2 diabetes mellitus.