关键词: 糖尿病, 2型；达格列净；甘精胰岛素；体脂分布；骨矿含量

Abstract: Background　It has been identified through background research that obesity and overweight，especially abdominal obesity（central obesity），are a major reason for significant increased prevalence of type 2 diabetes mellitus（T2DM）.Therefore，the clinical goal for T2DM patients should not only target lowering glucose，but also controlling diet and body fat，as well as exercising appropriately.Objective　To investigate the effects of dapagliflozin on adiponectin level，body fat distribution and bone mineral content in overweight T2DM patients.Methods　60 overweight T2DM patients admitted to the Department of Endocrinology，No.7 Medical Center，General Hospital of the People’s Liberation Army from February to August 2019 were selected for this study，and evenly randomized into treatment group （using dapagliflozin with metformin） and control group （using insulin glargine with metformin），treated for 12 weeks.Intergroup comparisons were made in terms of pre- and post-treatment fasting plasma glucose（FPG），glycosylated hemoglobin（HbA1c），blood pressure〔systolic blood pressure（SBP） and diastolic blood pressure（DBP）〕，blood lipid parameters〔triacylglycerol（TG），total cholesterol（TC），high-density lipoprotein cholesterol（HDL-C），low-density lipoprotein cholesterol（LDL-C）〕，adiponectin，BMI，waist-to-hip ratio，body fat （including body fat percentage，body fat mass and lean body mass），whole body bone mineral content for men，A/G ratio，body fat distribution（including both arms and both legs，and trunk） for both fat mass and lean mass，bone mineral content of all body parts and L1-4 bone mineral content of men.Results　Post-treatment FPG，HbA1c，TC，HDL-C and LDL-C showed no significant intergroup differences（P>0.05）.But post-treatment SBP，DBP and TG were lower and post-treatment adiponectin was higher in the treatment group（P<0.05）.Post-treatment lean body mass showed no significant differences between the groups，so did post-treatment whole body bone mineral content for men （P>0.05）.The treatment group showed lower levels of BMI，waist-to-hip ratio，body fat percentage，body fat mass and A/G ratio than the control group at the end of treatment（P<0.05）.Pre- and post-treatment fat mass and lean mass for both arms and legs，and trunk were similar in both groups（P>0.05）.Bone mineral contents for both arms and legs，and trunk and L1-4 for men were similar in both groups either before or after treatment（P>0.05）.Conclusion　While both insulin glargine and dapagliflozin could effectively lower glucose level，dapagliflozin was more superior to insulin glargine in improving blood pressure and blood lipid，reducing abdominal fat accumulation，increasing adiponectin level in over weight T2DM patients，without adverse effects on muscle content and bone mineral content.

Key words: Diabetes mellitus, type 2；Dapagliflozin；Insulin glargine；Body fat distribution；Bone mineral content