吡格列酮联合二甲双胍对初诊2型糖尿病患者血清视黄醇结合蛋白4水平的影响  

Effect of pioglitazone combined with metformin on serum retinol-binding protein 4(RBP4) in patients with newly diagnosed type 2 diabetes

作　　者：陈红梅[1] 李洪彬[1] 邱谷[2] 戴士荣 汤永新[3] 

机构地区：[1]江苏南通市第二人民医院内分泌科,226002 [2]江苏南通市第二人民医院检验科,226002 [3]江苏南通市第二人民医院医务科,226002

出　　处：《中国临床保健杂志》2016年第4期366-368,共3页Chinese Journal of Clinical Healthcare

基　　金：江苏省南通市科技计划资助项目(S8006)

摘　　要：目的观察吡格列酮联合二甲双胍对初诊2型糖尿病(T2DM)患者血清视黄醇结合蛋白4(RBP4)水平的影响。方法 60例初发T2DM(A组)患者随机分二组,30例予二甲双胍(A1组)和30例予吡格列酮联合二甲双胍(A2组)治疗12周,30例正常体检者为对照组(B组)。观察两组治疗前后空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、RBP4、血脂、空腹胰岛素(FIns)、体质量指数(BMI)、腰臀比(WHR)及胰岛素抵抗指数(HOMA-IR)、Homeβ细胞功能指数(HBCI)的变化。结果 (1)A组血清RBP4水平明显高于B组(P<0.05);(2)A1组和A2组治疗后FPG、Hb Alc、FIns、RBP4、HOMA-IR、BMI、WHR、低密度胆固醇(LDL-C)均明显低于治疗前(P<0.05)。A2组血清RBP4、HOMA-IR和LDL-C更低于A1组(P<0.05)。A1组、A2组治疗后HBCI均明显高于治疗前(P<0.05),两组治疗后比较差异无统计学意义(P>0.05)。结论二甲双胍联合吡格列酮可更有效降低血清RBP4,更好发挥降血糖,改善胰岛素抵抗和β细胞功能的疗效。Objective To observe the effects of pioglitazone combined with metformin on serum RBP4 level in patients with newly diagnosed type 2 diabetes mellitus（T2DM）and examine the relationship between RBP4 and T2DM, and the treatment mechanism of medicine.Methods Sixty patients with newly-diagnosed T2DM （A group）were ran-domly divided into two groups,30 cases were treated with metformin（A1 group）,30 cases were treated with pioglitazone and metformin（A2 group）for 12 weeks,30 health examination clients were selected as control（B group）.Fasting plas-ma glucose（FBG）,glycosylated hemoglobin （HbAl c）,RBP4,blood fat,fasting plasma insulin（FIns）,the body mass index （BMI）,the waist-hip-ratio（WHR）and HOMA-insulin resistance index （HOMA-IR）,Homeβcell function index （HBCI）before the treatment.Results （1 ）The serum RBP4 level of A group was higher than B group （P 〈0.05）.（2）After the treatment, the FPG,HbAl c,FIns,RBP4,HOMA-IR,BMI,WHR,Low density lipoprotein cho-lesterol （LDL-C）were significantly decreased in A1 and A2 groups （P 〈0.05）,and the effect of the A2 group was su-perior to that in the A1 group.HBCI was significantly increased compard with that befor treatment（P 〈0.05）,there were no statistical differences between two groups after treatment（P 〉0.05）.Conclusions The combined treatment with metformin and pioglitazone can decrease plasma glucose level and improve IR and β-cell function better.

关 键 词：糖尿病 2 型 视黄醇结合蛋白质类 二甲双胍 噻唑烷二酮类 

分 类 号：R587.1[医药卫生—内分泌]