利拉鲁肽对早期糖尿病肾病的影响及与VEGF、VEGF-A变化的关系  

Effects of liraglutide on early diabetic nephropathy and its relationship with the changes of VEGF and VEGF-A

作　　者：李青[1] 曹卫娟[1] 周国艳[1] 阳丽辉 

机构地区：[1]湖南师范大学附属湘东医院内分泌科,株洲醴陵412200

出　　处：《湘南学院学报（医学版）》2017年第4期6-11,共6页Journal of Xiangnan University（Medical Sciences）

基　　金：湖南省卫计委科研计划课题项目(B2015-62)

摘　　要：目的探讨利拉鲁肽对早期2型糖尿病肾病的影响及其与VEGF、VEGF-A的关系,了解利拉鲁肽能否改善早期2型糖尿病肾病及是否与VEGF、VEGF-A的表达有关。方法选取44例口服二甲双胍至少1个月以上,血糖控制欠佳的早期2型糖尿病肾病患者随机分为两组,每组22例,分别加用利拉鲁肽和甘精胰岛素各治疗12周,检测治疗前后两组血清VEGF、VEGF-A及24 h尿微量白蛋白、血糖等的变化。结果与治疗前比较,早期2型糖尿病肾病患者使用利拉鲁肽、甘精胰岛素治疗后,空腹及餐后2 h血糖、糖化血红蛋白均下降(P<0.01),且两组治疗前后降幅相当(P>0.05)。治疗后,利拉鲁肽组VEGF、VEGF-A、24 h尿微量白蛋白较治疗前下降(P<0.01),而甘精胰岛素组无明显变化(P>0.05)。结论利拉鲁肽对糖尿病肾病的保护作用独立于降糖外,推测可能与其抑制VEGF、VEGF-A的过表达有关。Objective To investigate the effects of liraglutide on early type 2 diabetic nephropathy and its relationship with VEGF and VEGF-A,so as to know the effects in improving the early type 2 diabetic nephropathy,and whether the protection mechanism to diabetic nephropathy is related with VEGF and VEGFA.Methods 44 patients,who had micro albuminuria（ early DN） and did not control their serum glucose well after one-month treatment with metformin,were randomly divided into two groups,22 patients per group.Combined with metformin treatment,one group was treated with liraglutide and the other was treated with insulin glargine for 12 weeks. Blood and urine samples were collected to detect the changes of serum VEGF,VEGF-A and 24 h urinary micro-albumin before and after treatment. Results Compared with those before treatment,the levels of fasting and 2 h postprandial blood glucose and Hb Alc were decreased in the patients with early type 2 diabetic nephropathy,who was treated by liraglutide or insulin glargine（ P〈 0.01）,and the two groups had a comparable reduction before and after treatment（ P〉 0.05）. After treatment,the levels of VEGF,VEGF-A and 24 h urinary albumin were decreased in liraglutide group（ P〈 0.01）,while not considerable in insulin glargine group（ P 0. 05）. Conclusion The protective effect of liraglutide on diabetic nephropathy is independent of hypoglycemia,it is suggested that it may be related to its inhibition of the overexpression of VEGF and VEGF-A.

关 键 词：利拉鲁肽 早期糖尿病肾病 血管内皮生长因子 血管内皮生长因子-A 

分 类 号：R587.2[医药卫生—内分泌]