Effects of pioglitazone metformin combined with dapagliflozin on visceral fat area and serum LHP level in T2DM patients

LI Yingchun; HU Jinyu; HOU Li; YE Yilan

doi:10.3969/j.issn.1002-266X.2025.12.012

Abstract：Objective To explore the effects of pioglitazone metformin combined with dapagliflozin on visceral fat ar-ea and serum lipid hydroperoxide(LHP)level in type 2 diabetes mellitus(T2DM)patients.Methods A total of 130 pa-tients with T2DM were enrolled and randomly assigned into the control group(65 cases)and observation group(65 cas-es).Patients in the control group received pioglitazone and metformin,while patients in the observation group received dapagliflozin in addition to pioglitazone and metformin.We compared the blood glucose levels[glycated hemoglobin(HbA1C),fasting plasma glucose(FPG),and 2-hour postprandial blood glucose(2 h PG)],pancreatic function[fasting insulin(FINS)and insulin resistance index(HOMA-IR)],visceral fat area(VFA),oxidative stress levels[LHP,malo-ndialdehyde(MDA),and superoxide dismutase(SOD)]before and after treatment in the two groups,as well as the inci-dence of adverse reactions.Results After treatment,both groups exhibited decreased levels of HbA1C,FPG,2 h PG,FINS,HOMA-IR,LHP,MDA,and VFA,and an increased level of SOD.Compared with the control group,the observa-tion group had significantly lower levels of HbA1c,2 h PG,FPG,HOMA-IR,FINS,MDA,LHP and VFA,and a higher level of SOD(all P<0.05).In the observation group,there were 2 cases of edema and 1 case of weight gain,with an ad-verse reaction incidence of 4.62%(3/65);in the control group,there was 1 case of edema and 1 case of digestive tract symptoms,with an incidence of 3.08%(2/65).No statistically significant difference was found in the incidence of ad-verse reactions between the two groups(P>0.05).Conclusion The combination of dapagliflozin and pioglitazone met-formin can not only reduce blood glucose and improve insulin resistance,but also decrease VFA and lower serum LHP lev-el in patients with T2DM.