Objective To investigate the effect of semaglutide combined with metformin on the ratio of apolipoprotein B to apolipoprotein A1 (ApoB/ApoA1), omentin-1and fibroblast growth factor-21 (FGF-21) levels in patients with type 2 diabetes mellitus (T2DM).

Methods A total of 86 patients with T2DM were selected as research objects and randomly divided into control group (treated with metformin) and observation group (treated with semaglutide and metformin). The fasting blood glucose, 2-hour postprandial blood glucose, glycated hemoglobin, blood lipid indicators, insulin autoantibody (IAA), insulin resistance index (HOMA-IR), pancreatic β-cell function index (HOMA-β), ApoB/ApoA1, omentin-1, and FGF-21 levels before and after treatment were compared between the two groups. The occurrence of adverse reactions in both groups was also compared.

Results After treatment, the fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels in the observation group were significantly lower than those in the control group (P < 0.05). After treatment, the total cholesterol, triglycerides, and low-density lipoprotein cholesterol levels in the observation group were significantly lower than those in the control group, while the high-density lipoprotein cholesterol level was significantly higher than that in the control group (P < 0.05). After treatment, the HOMA-IR and IAA in the observation group were significantly lower than those in the control group, while the HOMA-β was significantly higher than that in the control group (P < 0.05). After treatment, the serum omentin-1 level in the observation group was significantly higher than that in the control group, while the ApoB/ApoA1 and FGF-21 levels were significantly lower than those in the control group (P < 0.05). In the control group, there were 1 case of diarrhea and 2 cases of constipation, with a total incidence of adverse reactions of 6.98%; in the observation group, there were 1 case of hypoglycemia and 1 case of diarrhea, with a total incidence of adverse reactions of 4.65%; there was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05).

Conclusion Semaglutide combined with metformin can effectively control blood glucose and blood lipid levels in patients with T2DM, increase omentin-1 level, and reduce ApoB/ApoA1 and FGF-21 levels.