Objective To assess the effects of sitagliptin and metformin on insulin resistance, blood lipid and blood pressure in patients with type 2 diabetes mellitus(T2DM). Methods 60 patients with T2DM, a history of less than 5 years, were randomly divided into three groups: the sitagliptin group(A),the metformin group (B), the metformin+sitagliptin group(C). Before taking into the measurement, patients should be tested in weight, height, fasting blood glucose, fasting insulin, HbA1c, TG, TCH, LDL-C, SBP, DBP, and calculating body mass index( BMI) , the insulin resistance index ( HOMA-IR) . After 12 weeks of medication, all the data were retested. Results ① After treatment compared with before, FBG, HbA1c, BMI, TG, TCH, LDL-C, SBP, DBP decreased (P<0.05). There was statistically significant difference between pre-therapy and post-treatment in group C. ②Group A compared with group C, group B compared with group C, the levels of FBG, HbA1c, TG, TCH, LDL-C, SBP, DBP were statistically significant (P<0.05). Group A and group B were not statistically significant. There was no statistical significance between the three groups in BMI and HOMA-IR. Conclusion Sitagliptin and met-formin have the effects in lowing glucose, improving lipids, reducing insulin resistance, and combination therapy is better than single drug effect.%目的观察西格列汀联合二甲双胍对2型糖尿病患者胰岛素抵抗、血脂和血压等心血管危险因素的影响。方法选择病史在5年以内的2型糖尿病患者60例,随机分为3组：西格列汀( A)组、二甲双胍( B)组、二甲双胍+西格列汀( C)组。服药前和服药后12周分别检测患者体重、身高、空腹血糖( FBG )、空腹胰岛素( FINS )、糖化血红蛋白(HbA1c)、三酰甘油(TG)、胆固醇(TCH)、低密度脂蛋白(LDL-C)、收缩压(SBP)、舒张压(DBP),并计算其体重指数(BMI)、胰岛素抵抗指数(HOMA-IR)。结果淤各组用药前比较,FBG、HbA1c、BMI、TG、TCH、LDL-C、SBP、DBP 均下降(P<0.05)。 C组HOMA-IR用药前后比较差异有统计学意义(P<0.05)。于用药后,A 组与 C 组及 B 组与 C 组FBG、HbA1c、TG、TCH、LDL-C、SBP、DBP比较差异均有统计学意义(P<0.05)；A组与B组及A组与C组BMI比较差异有统计学意义(P<0.05),B组与C组BMI比较差异无统计学意义；用药后3组HOMA-IR组间比较差异无统计学意义。结论西格列汀、二甲双胍对降低血糖、调节血脂、控制血压、减轻胰岛素抵抗均有作用。二者联合用药后其降糖、调脂、降压、减轻胰岛素抵抗作用较单独用药效果更好。
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