格列美脲与沙格列汀对2型糖尿病患者氧化应激和胰岛素抵抗的影响  

Effects of glimepiride and saxagliptin on oxidative stress and insulin resistance in patients with type 2 diabetes mellitus

作　　者：李会柏 魏亚超[1] 王振贤[1] 王颖霞[1] 张志佳 LI Huibo;WEI Yachao;WANG Zhenxian(Department of Endocrinology,Handan Central Hospital,Hebei,Handan 065001,China)

机构地区：[1]河北省邯郸市中心医院内分泌一科,056001

出　　处：《河北医药》2020年第14期2100-2103,2108,共5页Hebei Medical Journal

摘　　要：目的探究格列美脲与沙格列汀对2型糖尿病患者氧化应激、胰岛素抵抗等的影响。方法采用数字随机表法将60例2型糖尿病患者分为对照组(n=30,给予沙格列汀治疗,5 mg,1次/d)及联合组(n=30,在对照组基础上给予格列美脲,1~4 mg,1次/d),对比2组患者治疗效果及治疗前后糖脂代谢水平[空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)]、氧化应激[超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)、活性氧类物质(ROS)]、胰岛素抵抗指数(HOMA-IR)等变化。结果联合组患者治疗有效率显著高于对照组(P<0.05),治疗3个月2组HOMA-IR均较治疗前低,而且联合组低于对照组,(P<0.05)。治疗后,对照组除HDL水平外,均有改善,联合组患者FPG、HbA1c、TC、TG、LDL、HDL水平均有显著改善,且均优于对照组患者(P<0.05)。治疗后,2组患者氧化应激水平均有显著改善,且联合组患者SOD、GSH-PX、ROS水平均显著优于对照组(P<0.05)。结论格列美脲与沙格列汀联合治疗2型糖尿病患者,能够改善氧化应激、胰岛素抵抗,提高治疗效果,值得推广。Objective To investigate the effects of glimepiride and saxagliptin on oxidative stress and insulin resistance in patients with type 2 diabetes mellitus.Methods Sixty patients with T2DM were divided into control group(n=30)and combination treatment group(n=30).The patients in control group were treated by saxagliptin,5mg once,qd,however,the patients in combination treatment group,on the basis of the control group,were treated by glimepiride.The therapeutic effect and changes in glucose and lipid metabolism levels[fasting blood glucose(FBG),glycated hemoglobin(HbA1c),total cholesterol(TC),triacylglycerol(TG),low density lipoprotein(LDL),high density lipoprotein(HDL)],oxidative stress[superoxide dismutase(SOD),glutathione peroxidase(GSH-PX),reactive oxygen species(ROS)],and insulin resistance index(HOMA-IR)were observed and compared between the two groups.Results The effective rate in combination treatment group was significantly higher than that in control group(P<0.05).The HOMA-IR levels at 3 months after treatment in both groups were significantly lower than those before treatment,moreover,which in combination treatment group were significantly lower than those in control group(P<0.05).After treatment,the indexes mentioned above were improved in control group except for HDL.The levels of FPG,HbA1c,TC,TG,LDL,HDL in combination treatment group were significantly improved,which were superior to those in control group(P<0.05).After treatment,the levels of oxidative stress in both groups were significantly improved,and the levels of SOD,GSH-PX,and ROS in combination treatment group were significantly better than those in control group(P<0.05).Conclusion The glimepiride combined with saxagliptin in treatment of type 2 diabetes mellitus can ameliorate oxidative stress and insulin resistance,and improve the therapeutic effect.Therefore,it is worthy of popularization in clinical practice.

关 键 词：格列美脲 沙格列汀 2型糖尿病 氧化应激 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]