Effects of dapagliflozin combined with metformin on glycolipid metabolism,adipokines and miR-155 and PTP1B levels in obese type 2 diabetes mellitus patients
Tang Yu
Bai Hongchao
Song Dan
Shao Fei
Abstract：Objective To investigate the effects of dapagliflozin combined with metformin on glycolipid metabolism,adipokines,and microRNA-155(miR-155)/protein tyrosine phosphatase 1B(PTP1B)in obese type 2 diabetes mellitus(T2DM)patients.Methods From July 2021 to June 2024,103 obese T2DM patients were prospectively enrolled and randomized into Group A(pioglitazone+metformin,n=51)and Group B(dapagliflozin+metformin,n=52)using an envelope method.Glycolipid parameters[total cholesterol(TC),triglycerides(TG),high-/low-density lipoprotein cholesterol(HDL-C/LDL-C),fasting blood glucose(FBG),HbA1c],adipokines[adiponectin(ADP),leptin,visfatin,nesfatin-1],miR-155/PTP1B,and body composition[BMI,waist-to-hip ratio,body fat％,visceral fat index(VFI)]were analyzed.Results After treatment,Group B showed significant improvements in metabolic parameters compared to Group A.Specifically,Group B had higher levels of HDL-C(1.29±0.21 vs.1.14±0.19 mmol/L),adiponectin(7.25±1.57 vs.5.46±1.14 mg/L),and nesfatin-1(2.87±0.71 vs.2.24±0.67 μg/L),while total cholesterol(4.54±0.58 vs.5.03±0.67 mmol/L),LDL-C(2.43±0.47 vs.2.66±0.54 mmol/L),leptin(21.33±4.56 vs.28.87±5.13 μg/L),fasting blood glucose(7.13±0.89 vs.7.64±1.04 mmol/L),HbA1c(7.68％±1.05％vs.8.14％±1.13％),and visfatin(36.04±7.11 vs.45.63±7.56 μg/L)were significantly lower(all P＜0.05).In terms of molecular regulation,Group B exhibited a greater increase in miR-155 expression and a more pronounced reduction in PTP1B levels compared to Group A(P＜0.05).Additionally,Group B experienced more marked improvements in body composition,including lower BMI(28.04±0.57 vs.28.78±0.74 kg/m2),waist-to-hip ratio(0.92±0.04 vs.0.94±0.06),body fat percentage(28.79±3.80％vs.30.41±4.13％),and visceral fat index(11.18±1.36 vs.11.79±1.47)(P＜0.05).No significant differences were observed between groups in triglyceride levels or adverse events(P＞0.05).Conclusion Dagliflozin combined with metformin is superior to pioglitazone combined with metformin in improving glucose-lipid metabolism,regulating adipokine,miR-155,and PTP1B expression,and reducing visceral fat in obese type 2 diabetic patients.
Keywords：DagliflozinMetforminObesityType 2 diabetesGlucolipid metabolismAdipokines
Publication Date：2025-08-31
Online Publishing Date：2025-09-24(First online date of this platform, not the publication date of the document)
Pages：5( 677-681 )