西格列汀对早期糖尿病肾病患者血清趋化素的影响  

Effects of sitagliptin on serum chemerin in early diabetic patients with nephropathy

作　　者：王兴洲[1] 张红[1] 章向成[1] 张日东[1] 石敏[1] 吕述军[1] 高鹏霞[1] 

机构地区：[1]南京医科大学附属淮安第一医院内分泌科,江苏淮安223300

出　　处：《徐州医学院学报》2015年第12期825-828,共4页Acta Academiae Medicinae Xuzhou

基　　金：国家自然科学基金（81200595/81400807）;江苏省卫计委科研项目（H201253）;淮安市科技支撑计划社会发展项目（HASZ2013031）

摘　　要：目的：观察西格列汀治疗早期糖尿病肾病（ diabetic nephropathy， DN）的疗效及对血清趋化素（ chemer-in）水平的影响。方法选择60例2型糖尿病（ type 2 diabetes mellitus， T2DM）并发早期DN患者，随机分为治疗组（30例）和对照组（30例），2组均应用胰岛素控制血糖，治疗组加用西格列汀100 mg／d，疗程8周。治疗前后检测血清肿瘤坏死因子－α（ tumor necrosis factor－α， TNF－α）、超敏C反应蛋白（ high－sensitivity C－reactive pro-tein， hs－CRP）、chemerin、血糖、血脂、胰岛素以及尿微量白蛋白排泄率（ urinary albumin excretion rates， UAER）的变化。结果2组治疗前后空腹血糖（ fasting blood glucose， FBG）、空腹胰岛素（ fasting insulin， FINS）、甘油三酯（triglyceride， TG）、总胆固醇（total cholesterol， TC）以及胰岛素抵抗指数（HOMA－IR）变化无统计学意义（P＞0．05）。2组UAER治疗后均较治疗前下降（P＜0．05），治疗组低于对照组（P＜0．05）。治疗组治疗后血清TNF－α、hs－CRP、chemerin均较治疗前降低（P＜0．05），对照组上述检测指标差异无统计学意义（P＞0．05）。治疗组治疗后TNF－α、hs－CRP、chemerin均低于对照组（P＜0．05）。结论西格列汀能够在胰岛素降糖治疗基础上减轻炎症、减少UAER，对早期DN起到保护作用，chemerin可能在DN病理机制中发挥作用。Objective To investigate sitagliptin＇s efficacy and its effects on serum chemerin in early diabetic ne-phropathy （DN） patients.Methods A total of 80 type 2 diabetes mellitus （T2DM） patients with early DN were ran-domly divided into a treatment group and a control group （n=30）.Both groups were treated with insulin to control blood glucose, in which patients in the treatment group were administrated with 100 mg/d sitagliptin for eight weeks.Then, the levels of serum tumor necrosis factor-α（TNF-α）, high-sensitivity C -reactive protein （hs-CRP）, chemerin, blood glucose, lipids and insulin and urinary albumin excretion rates （ UAERs） were measured before and after treat-ment.Results No statistical significances were found in fasting blood glucose （ FBG） , fasting insulin （ FINS） , triglyc-eride （TG）, total cholesterol （TC） levels and HOMA -IR in both groups before and after treatment （P 〉0.05）. UAERs were remarkably reduced after treatment in both groups （P〈0.05）, where more decreases were detected in the treatment group than in the control group （P〈0.05）.The amounts of TNF-α, hs-CRP and chemerin in the treatment group were examined after therapy, which were substantially lower than those before treatment （P〈0.05）.Similar chan-ges were not seen in the control group （P〉0.05）.After therapy, the treatment group showed obviously decreased levels of TNF -α, hs-CRP and chemerin in comparison with the control （P〈0.05）.Conclusion Based on insulin therapy for blood glucose control, sitagliptin can relieve inflammation, reduce UAER, and prevent the onset of early DN where chemerin may be involved.

关 键 词：2型糖尿病 早期糖尿病肾病 西格列汀 血清趋化素 炎症 

分 类 号：R587.2[医药卫生—内分泌]