Influence of metformin hydrochloride and empagliflozin on bone metabolism and blood pressure of elderly patients with diabetes mellitus
Xu Wei
Gao Xintong
Cai Yanyang
Luo Liying
Tao Lizhen
Abstract：Objective To observe the influence of metformin hydrochloride and empagliflozin tablets on glucolipid metabo-lism,bone metabolism and blood pressure of elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 96 elderly patients with T2DM who were treated in the Baoji Hospital of Traditional Chinese Medicine from February 2022 to January 2024 were divided into the single drug group(n=45,metformin)and the combined group(n=51,metformin hydrochloride and empagli-flozin tablets)according to different drug treatments.The treatment course of the two groups was 6 months.The blood glucose,blood lipids,insulin resistance indexes(HOMA-IR),islet β cell function index(HOMA-β),bone metabolism indicators[osteocalcin(OST),total type 1 collagen amino terminal extension peptide(PINT),β-collagen special sequence(β-CTX)and total vitamin D(vit-D)),blood pressure and adverse reactions were observed and compared between the two groups.Results The levels of FPG,2 h PG and HbA1c of the combined group and the single drug group were respectively((7.03±1.25)mmol·L-1,(8.45±1.16)mmol·L-1 and(6.24±1.17)%;(9.52±1.27)mmol·L-1,(10.53±1.10)mmol·L-1 and(7.13±1.05)% after the treatment,lower than(11.63±3.11)mmol·L-1,(15.29±3.51)mmol·L-1 and(9.22±2.11)%;(11.54±3.15)mmol·L-1,(15.21±3.64)mmol·L-1 and(9.19±2.08)% before the treatment;the levels of the above indexes of the combined group were lower than those of the single drug group(t=9.667,8.982,3.901,all P<0.05).The levels of TC,TG and LDL-C of the combined group and the single drug group were respectively(3.81±0.40)mmol·L-1,(0.95±0.28)mmol·L-1 and(2.73±0.29)mmol·L-1;(4.36±0.62)mmol·L-1,(1.46±0.42)mmol·L-1 and(3.24±0.26)mmol·L-1 after the treatment,lower than(5.02±1.12)mmol·L-1,(2.03±0.72)mmol·L-1 and(3.90±0.41)mmol·L-1;(4.96±1.14)mmol·L-1,(1.92±0.64)mmol·L-1 and(3.78±0.50)mmol·L-1 before the treatment;the levels of the above indexes of the com-bined group were lower than those of the single drug group(t=5.224,7.074,9.023,all P<0.05).The HDL-C levels of the combined group and the single drug group were respectively(1.48±0.21)mmol·L-1 and(1.19±0.27)mmol·L-1 after the treatment,higher than(0.76±0.53)mmol·L-1 and(0.85±0.36)mmol·L-1 before the treatment;the levels of the above index of the combined group were higher than those of the single drug group(t=5.909,P<0.05).The HOMA-IR levels of the combined group and the single drug group were respectively(1.24±0.21)and(1.93±0.37)after the treatment,lower than(4.11±0.49)and(4.08±0.51)before the treatment;the HOMA-IR level of the combined group was lower than that of the single drug group(t=11.403,P<0.05).The levels of HOMA-β of the combined group and the single drug group were respectively(58.84±6.13)and(50.32±6.25)after the treatment,higher than(32.28±5.25)and(32.47±5.68)before the treatment;the HOMA-β level of the combined group was higher than that of the single drug group(t=6.734,P<0.05).The levels of OST,PINT,β-CTX and vit-D of the combined group and the single drug group were respectively(3.51±1.12)μg·L-1,(43.40±5.49)ng·mL-1,(270.94±23.26)pg·mL-1 and(27.68±5.96)ng·mL-1;(3.48±1.09)μg·L-1,(43.77±5.63)ng·mL-1,(272.16±23.57)pg·mL-1 and(26.37±4.27)ng·mL-1 after the treatment,and were respectively(3.18±1.03)μg·L-1,(41.53±5.29)ng·mL-1,(263.43±21.28)pg·mL-1 and(27.52±5.78)ng·mL-1;(3.21±1.02)μg·L-1,(41.87±5.34)ng·mL-1,(263.71±21.53)pg·mL-1 and(26.42±4.15)ng·mL-1 before the treatment,and there were no significant differences(tcombined group=1.549,1.752,1.701,1.276,Pcombined group=0.125,0.083,0.092,0.205;tsingle drug group=1.213,1.643,1.776,1.037,Psingle drug group=0.228,0.104,0.079,0.303);there were no significant differences in the above indexes between the combined group and the single drug group(t=0.133,0.326,0.255,1.223,P=0.895,0.745,0.799,0.224).The systolic blood pressure and diastolic blood pressure of the combined group and the single drug group were respectively(122.35±4.27)mm Hg(1 mm Hg≈0.133 kPa)and(78.71±2.31)mm Hg;(129.51±4.19)mm Hg and(83.16±2.42)mm Hg after the treatment,lower than(136.28±3.21)mm Hg and(88.92±3.71)mm Hg;(135.37±3.29)mm Hg and(89.18±3.25)mm Hg before the treatment;the levels of the above indexes of the combined group were lower than those of the single drug group(t=8.271,9.211,all P<0.05).The total incidence rate of adverse reactions was 11.11% (5/45)in the single drug group,17.65% (9/51)in the combined group(χ2=0.820,P=0.365).Conclusion Compared with single metformin therapy,met-formin hydrochloride and empagliflozin tablets can effectively control the blood glucose and improve the blood lipids,insulin resistance and blood pressure in treatment of the elderly patients with T2DM,and they have no significant influence on bone metabolism and do not increase adverse reactions,with good safety.
Keywords：Metformin hydrochloride and empagliflozin tabletsElderlyType 2 diabetes mellitusBlood glucoseInsulin resistanceBone metabolism
Publication Date：2025-07-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 625-630 )