那格列奈与阿卡波糖对2型糖尿病患者餐后血清游离脂肪酸水平的影响  

The effects of nateglinide versus acarbose on postprandial serum free fatty acid levels in patients with type 2 diabetes

作　　者：谢超[1] 王海宁[1] 林玉晶[1] 高洪伟[1] 洪天配[1] 

机构地区：[1]北京大学第三医院内分泌科,100191

出　　处：《中国糖尿病杂志》2009年第5期323-326,共4页Chinese Journal of Diabetes

基　　金：国家973计划资助项目(2006CB503900);北京市自然科学基金资助项目(7062067);国家自然科学基金资助项目(30771032;30700879)

摘　　要：目的比较那格列奈和阿卡波糖对新诊断2型糖尿病患者餐后血清游离脂肪酸(FFA)和甘油三酯(TG)的影响。方法 16例新诊断2型糖尿病患者随机分为两组,进行为期9周的自身交叉对照研究。前4周两组分别给予阿卡波糖(50mg,日三次)和那格列奈(120mg,日三次),而后停药清洗药物1周。后4周两组交换药物。在第1周和第6周的第1天,所有患者进行标准餐试验,同时服用阿卡波糖50mg或那格列奈120mg,测定0、30、60、120min的血糖、胰岛素、FFA及TG。在第4周和第9周末,测定空腹血糖、胰岛素、FFA、TG。结果单剂量那格列奈和阿卡波糖降低标准餐后血糖的效果相似。与阿卡波糖相比,那格列奈可显著增加2型糖尿病患者标准餐后30min胰岛素分泌水平,降低餐后120min血清FFA水平,但对餐后血清TG水平无明显影响。那格列奈或阿卡波糖治疗4周前后,空腹FFA和TG水平无显著改变。结论那格列奈在降低餐后血清FFA方面优于阿卡波糖,这可能与其部分恢复早时相胰岛素分泌有关。Objective To investigate the effects of nateglinide versus acarbose on postprandial serum free fatty acids （FFA） and triglyceride （TG） levels in patients with newly diagnosed type 2 diabetes. Methods A crossover trial of nateglinide （120 mg rid for 4 weeks） and acarbose （50 mg tid for another 4 weeks） treatment was conducted on 16 drug naive patients with newly diagnosed type 2 diabetes during a total period of 9 weeks. In order to assess the acute effects of nateglinide or acarbose On postpradial glucose, insulin, FFA and TG levels, a standard meal was consumed with the first dose of medication on the first day of each treatment arm. Blood samples were collected from both arms at 0, 30, 60, and 120 min after the standard meal test. Plasma glucose, serum insulin, FFA and TG were measured. Results A single dose of nategtinide and acarbose showed similar efficiencies for lowering postprandial hyperglycemia. Compared with acarbose, nategtinide significantly increased postprandial 30-min insulin secretion and decreased postprandial 120-min FFA levels after a standard meal test in the patients with type 2 diabetes. Postprandial TG levels were not significantly different between nateglinide and acarbose treatment. The fasting levels of serum FFA and TG were unchanged after 4 weeks of treatment with either nateglinide or acarbose. Conclusions Nateglinide has an advantage in the reduction of postprandial FFA levels in comparison with acarbose, which may be associated with the partial restoration of early phase insulin secretion resulted from nateglinide.

关 键 词：那格列奈 阿卡波糖 游离脂肪酸 甘油王酯 

分 类 号：R587.1[医药卫生—内分泌] R259.422.2[医药卫生—内科学]