2026 年第 10 期 第 21 卷

限时饮食联合司美格鲁肽对超重2型糖尿病患者肠道菌群及糖脂代谢的影响

Effects of time-restricted feeding combined with semaglutide on gut microbiota and glucose-lipid metabolism in overweight patients with type 2 diabetes mellitus

作者：李倩玉高佳侯丽萍翟思思李晓龙

英文作者：Li Qianyu Gao Jia Hou Liping Zhai Sisi Li Xiaolong

单位：哈励逊国际和平医院（河北省衡水市人民医院）内分泌科，衡水053000

英文单位：Department of Endocrinology Harrison International Peace Hospital (Hengshui People′s Hospital Hebei Province) Hengshui 053000 China

关键词：2型糖尿病；超重；限时饮食；司美格鲁肽；糖脂代谢；肠道菌群

英文关键词：Type2diabetesmellitus;Overweight;Time-restrictedfeeding;Semaglutide;Glucose-lipidmetabolism;Gutmicrobiota

• 摘要：

• 目的  探究限时饮食联合司美格鲁肽对超重2型糖尿病（T2DM）患者肠道菌群及糖脂代谢的影响。方法 选取2024年1—12月于哈励逊国际和平医院接受干预的100例超重T2DM患者作为研究对象。采用随机数字表法将患者分为对照组与观察组，每组50例。对照组采用司美格鲁肽治疗，观察组在对照组基础上联合限时饮食干预，2组均连续治疗12周。比较2组患者体重指数、腰臀比、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹胰岛素、餐后2 h胰岛素、稳态模型胰岛素抵抗指数（HOMA-IR）、肠道菌群水平。结果 治疗后，2组患者体重指数和腰臀比均低于治疗前［对照组：（28.2±2.1）kg/m2比（29.4±2.3）kg/m2，（0.81±0.13）比（0.96±0.18）；观察组：（26.6±1.8）kg/m2比（29.4±2.4）kg/m2，（0.70±0.09）比（0.94±0.19）］，且观察组均低于对照组，差异均有统计学意义（t=3.842，P=0.001；t=4.919，P=0.001）。治疗后，2组总胆固醇、甘油三酯、低密度脂蛋白胆固醇、空腹血糖、糖化血红蛋白、餐后2 h血糖、空腹胰岛素、餐后2 h胰岛素、肠球菌属、大肠埃希菌属水平、HOMA-IR均低于治疗前，且观察组均低于对照组，差异均有统计学意义（均P＜0.05）。治疗后，2组拟杆菌属、双歧杆菌属、乳酸杆菌属水平均高于治疗前，且观察组均高于对照组，差异均有统计学意义（均P＜0.05）。结论 限时饮食联合司美格鲁肽可调节超重T2DM患者肠道菌群结构，改善机体糖脂代谢水平，对超重T2DM患者具备较好的临床干预价值。

• Objective To explore the effects of time-restricted feeding combined with semaglutide on gut microbiota and glucose-lipid metabolism in overweight patients with type 2 diabetes mellitus (T2DM). Methods A total of 100 overweight patients with T2DM receiving intervention at Harrison International Peace Hospital from January to December 2024 were selected as research subjects. The patients were divided into control group and observation group by random number table method, with 50 cases in each group. The control group was treated with semaglutide, while the observation group received additional time-restricted feeding intervention on the basis of the control group. Both groups were treated continuously for 12 weeks. Body mass index, waist-hip ratio, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting blood glucose, 2 h postprandial blood glucose, glycated hemoglobin, fasting insulin, 2 h postprandial insulin, homeostasis model assessment of insulin resistance index (HOMA-IR) and gut microbiota levels were compared between the two groups. Results After treatment, body mass index and waist-hip ratio in both groups were lower than those before treatment ［control group: (28.2±2.1)kg/m2 vs (29.4±2.3)kg/m2, (0.81±0.13) vs (0.96±0.18); observation group: (26.6±1.8)kg/m2 vs (29.4±2.4)kg/m2, (0.70±0.09) vs (0.94±0.19)］, and those in the observation group were lower than those in the control group (t=3.842, P=0.001; t=4.919, P=0.001). After treatment, total cholesterol, triglyceride, low-density lipoprotein cholesterol, fasting blood glucose, glycated hemoglobin, 2 h postprandial blood glucose, fasting insulin, 2 h postprandial insulin, Enterococcus, Escherichia coli levels and HOMA-IR in both groups were lower than those before treatment, and those in the observation group were lower than those in the control group (all P＜0.05). After treatment, Bacteroides, Bifidobacterium and Lactobacillus levels in both groups were higher than those before treatment, and those in the observation group were higher than those in the control group (all P＜0.05). Conclusion Time-restricted feeding combined with semaglutide can modulate the gut microbiota structure and improve glycolipid metabolism in overweight patients with T2DM, exhibiting promising clinical intervention value for this population.