那格列奈对2型糖尿病患者空腹游离脂肪酸的影响  

Effects of Nateglinide on Fasting Free Fatty Acid in Type 2 Diabetic Patients

作　　者：王甫能[1] 廖志红[1] 胡国亮[1] 李延兵[1] 欧香忠[1] 翁建平[1] 

机构地区：[1]中山大学附属第一医院内分泌科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2006年第1期86-89,共4页Journal of Sun Yat-Sen University:Medical Sciences

摘　　要：目的探讨那格列奈对初诊2型糖尿病患者空腹游离脂肪酸的影响。方法42例从未进行降糖及降脂药物治疗的初诊2型糖尿病患者,随机分为那格列奈组及瑞格列奈组各21例,测定空腹游离脂肪酸(FFA)及空腹血糖(FPG)、标准餐后2h血糖(2hPG)、血脂谱,次日行静脉葡萄糖胰岛素释放试验(IVG-IRT)后,分组给予那格列奈60～90mg或瑞格列奈0.5～1.0mg,双盲治疗12周后,重复前述检查。结果37例完成试验,那格列奈组(18例)空腹FFA从(0.47±0.18)mmol/L下降到(0.36±0.16)mmol/L,平均下降(0.11±0.21)mmol/L(P<0.05),瑞格列奈组(19例)空腹FFA无显著变化,那格列奈组比瑞格列奈组空腹FFA降低有明显差异。两组患者血脂谱无明显变化,治疗后FPG、2hPG、HbA1c及胰岛素抵抗指数较治疗前均有明显下降(P<0.05),胰岛B细胞功能指数(HOMA-B)、IVG-IRT10min内急性胰岛素反应(AIR)均有明显增加(P<0.05),组间比较无明显差异(P>0.05)。结论那格列奈有降低空腹游离脂肪酸的倾向,其机制可能独立于改善胰岛功能之外。[Objective] To investigate the effects of nateglinide on fasting free fatty acids （FFA） in newly diagnosed type 2 diabetic patients. [Methods] The study was a 12-week double-blind, randomized, parallel controlled trial. Forty-two patients with newly diagnosed type 2 diabetes （fasting plasma glucose （FPG） 7 nunol/L- 13.3 mmol/L,or FPC,6 mmol/L -6.9 mmol/L and 2-h postload glucose （2hPG）≥11.1 mmol/L） without previous treatment of hypoglycaemic or antihyperlipidemic agents were randomized to receive monotherapy with repaglinide （n=21） （0.5 mg/meal, maximum dose 1 mg/meal） or nateglinide （n =21） （60 mg/meal, maximum dose 90 mg/meal） for 12 weeks. Before treatment, serum/ipid profiles, FPG, glycohemoglobin （HbAlc）, fasting FFA, 2hPG were measured,and in the next morning, intravenous glucose insulin releasing test （IVG-IRT） was performed, insulin levels 0 min, and 2 min, 4 min, 6 rain, 10 rain after intravenous injection of 50 ml 50% GS were measured. After 12 weeks follow up, the above measurement and IVG-IRT were repeated 24 h after medication cessation. [Results] Thirty-seven patients had completed the trial, 19 in repaglinide and 18 in nateglinide. There were no statistical differences in gender, age, duration and baseline body mass index （BMI）, FPG, 2hPG, HbAlc, TC, TG, HDL-C, LDL-C, FFA, FINS, HOMA-B （homeostatic model assessment of B-cell function）, HOMA-IRI （homeostatic model assessment insulin resistant index）, and AIR （acute insulin respond, incremental insulin area over the basal level from 0 to 10 min was calculated and defined as AIR） between the repaglinide group and the nateglinide group （P〉 0.05）. After treatment, FFA in nateglinide group had significantly reduced, from 0.47 mmol/L±0.18 mmol/L to 0.36mmol/L±0.16 mmol/L （P〈 0.05）. while there were no change for FFA in repaglinide group. No statistical differences in BMI, TC, TG, HDL-C, LDL-C, FINS averages of 37 patients between baseline and after treatment could be seen But FPG, 2hP

关 键 词：那格列奈 瑞格列奈 2型糖尿病 游离脂肪酸 

分 类 号：R587.1[医药卫生—内分泌]