endofocusFOCUS ЭндокринологияFOCUS. Endocrinology2713-01772713-0185ООО "Издательство "Перо"10.62751/2713-0177-2025-6-3-02endofocus-138Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИЭффективность и безопасность дулаглутида у пациентов сахарным диабетом 2 типа и ожирениемEfficacy and safety of dulaglutide in patients with type 2 diabetes and obesityhttps://orcid.org/0000-0001-8440-7809ГусенбековаД. Г.GusenbekovaD. G.

Гусенбекова Динара Гаджимагомедовна – к.м.н., доцент кафедры терапии и полиморбидной патологии им. академика М.С. Вовси ФГБОУ ДПО РМАНПО Минздрава России; врач-эндокринолог ГБУЗ «Городская поликлиника № 219 ДЗМ»

г. Москва

Dinara G. Gusenbekova – C. Sci. (Med.), Associate Professor, Department of Therapy and Polymorbid Pathology named after academician M.S. Vovsi, Russian Medical Academy of Continuous Professional Education; endocrinologist at City Polyclinic No. 219

Moscow

drdinara@yandex.ruhttps://orcid.org/0000-0002-7936-7619АметовА. С.AmetovA. S.

Аметов Александр Сергеевич – д.м.н., профессор, заведующий кафедрой эндокринологии ФГБОУ ДПО РМАНПО Минздрава России, заведующий сетевой кафедрой ЮНЕСКО по теме «Биоэтика сахарного диабета как глобальная проблема»

г. Москва

Alexander S. Ametov – D. Sci. (Med.), Head of the Department of Endocrinology

Moscow

alexander.ametov@gmail.comhttps://orcid.org/0000-0002-3684-9992КоротковаТ. Н.KorotkovaT. N.

Короткова Татьяна Николаевна – к.м.н., заведующий лабораторией клинической биохимии, аллергологии и иммунологии

г. Москва

Tatiana N. Korotkova – C. Sci. (Med.), Head of the Laboratory of Clinical Biochemistry, Allergology and Immunology

Moscow

tntisha@gmail.comФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииRussian Medical Academy of Continuous Professional EducationФГБУН «ФИЦ питания и биотехнологии»Federal Research Center for Nutrition, Biotechnology and Food Safety20251311202563611Copyright © Гусенбекова Д.Г., Аметов А.С., Короткова Т.Н., 20252025Гусенбекова Д.Г., Аметов А.С., Короткова Т.Н.Gusenbekova D.G., Ametov A.S., Korotkova T.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://endofocus.elpub.ru/jour/article/view/138Цель

Цель. Оценить влияние дулаглутида на маркеры метаболизма и состав тела у пациентов с сахарным диабетом 2 типа (СД2) и ожирением.

Материал и методы

Материал и методы. Проведено рандомизированное интервенционное исследование. Основную группу составили 57 человек с СД2 и ожирением различной степени выраженности, которым к терапии метформином был добавлен дулаглутид 1,5 мг 1 раз в неделю. В группу контроля вошли 53 пациента на монотерапии метформином в дозе 1,5–2,0 в cутки. Всем пациентам исходно и через год терапии проводилось обследование, включавшее оценку показателей гликемического контроля (гликированного гемоглобина, глюкозы крови натощак), антропометрических параметров (масса тела, индекс массы тела, окружность талии), уровня ирисина, высокочувствительного С-реактивного белка (вчСРБ), состава тела с помощью биоимпедансометрии.

Результаты

Результаты. Через год терапии добавление дулаглутида к терапии привело к статистически значимому снижению уровня гликированного гемоглобина с 7,2 [6,5; 9,3] до 6,5 [6,2; 8,4] % (p <0,05), массы тела со 109 [93–131] до 105 [65–129] кг (p <0,05), индекса массы тела с 39,2 до 37,05 кг/м2 (p <0,05), окружности талии со 125 [115–135] до 119 [91–127] см (p <0,05). Кроме того, в основной группе после проведения терапии отмечалось статистически значимое увеличение уровня ирисина с 4,01 [2,39–6,73] до 5,33 [1,46–8,38] нг/мл (p <0,05), снижение вчСРБ, уменьшение массы жировой ткани по результатам биоимпедансометрии.

Заключение

Заключение. Интенсификация терапии у пациентов с СД2 и ожирением путем добавления к метформину дулаглутида 1 раз в неделю способствовала статистически значимому улучшению показателей гликемического контроля, маркера воспаления вчСРБ, повышению уровня ирисина, уменьшению количества жировой ткани без снижения скелетномышечной массы.

The aim

The aim: to evaluate the effect of dulaglutide on metabolic markers and body composition in patients with type 2 diabetes mellitus (T2DM) and obesity.

Material and methods

Material and methods. A randomized interventional study was conducted. The study involved: a study group of 57 people with T2DM, obesity of varying severity, who added dulaglutide 1.5 mg once a week to metformin therapy. The control group consisted of 53 patients on metformin monotherapy at a dose of 1.5–2.0/day. All patients underwent an examination at the beginning and after a year of therapy, which included the determination of glycemic control parameters (glycated hemoglobin, fasting blood glucose), anthropometric parameters (body weight, body mass index (BMI), waist circumference (WC)), irisin, highly sensitive C-reactive protein (HCRP), body composition with using bioimpedance measurement.

Results

Results. After one year of therapy, the addition of dulaglutide led to a statistically significant decrease in the level of glycated hemoglobin from 7.2 [6.5; 9.3] to 6.5 [6.2; 8.4] % (p <0.05), body weight – from 109 [93–131] to 105 [65–129] kg (p <0.05), BMI – from 39.2 to 37.05 kg/m2 (p <0.05), WC – from 125 [115–135] to 119 [91–127] cm (p <0.05). In addition, the addition of dulaglutide to therapy led to a statistically significant increase in irisin from 4.01 [2.39–6.73] to 5.33 [1.46–8.38] ng/ml (p <0.05), there was also a significant decrease in HCRP, a decrease in adipose tissue mass according to the results of bioimpedance.

Conclusion

Conclusion. The intensification of therapy by adding dulaglutide once a week to metformin therapy in patients with T2DM and obesity contributed to a statistically significant improvement in glycemic control, a marker of inflammation, increased irisin, and a decrease in the amount of adipose tissue, while there was no decrease in musculoskeletal mass.

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The authors declare that there are no conflicts of interest present.