阿卡波糖联合西格列汀对2型糖尿病患者糖脂代谢紊乱及慢性炎性反应的作用  

Effects of acarbose combined with sitagliptin on glucose and lipid metabolism disorder and chronic inflammatory response in patients with type 2 diabetes mellitus

作　　者：陈鹤鸣[1] 张晓军[1] 陈浩[1] 唐国军 陈笑嬉 Chen Heming;Zhang Xiaojun;Chen Hao;Tang Guojun;Chen Xiaoxi(Department of Endocrinology,Ankang Central Hospital,Shaanxi Province,Shaanxi Province,Ankang 725000,China)

机构地区：[1]陕西省安康市中心医院内分泌科,725000

出　　处：《疑难病杂志》2022年第3期287-292,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：陕西省重点研发计划项目(2019SF-153)。

摘　　要：目的探讨阿卡波糖联合西格列汀对2型糖尿病患者糖脂代谢紊乱、胰岛素抵抗、慢性炎性反应的作用及可能机制。方法选取2016年6月—2020年6月安康市中心医院内分泌科诊治的新确诊2型糖尿病患者126例,根据服药情况分为对照组82例和观察组44例。除调整饮食、运动等生活方式以外,对照组给予阿卡波糖治疗,观察组给予阿卡波糖联合西格列汀治疗。观察2组患者治疗前、治疗3个月后血糖指标[FPG、2 hPG、HbA_(1c)、葡萄糖转运蛋白4(GluT4)、HOMA-IR]、血脂指标(TC、TG、LDL-C、HDL-C)及炎性指标(IL-6、TNF-α、CRP)的变化,采用Pearson相关性分析GluT4与HOMA-IR的相关性,并对2组的临床疗效、不良反应及安全性进行观察。结果治疗3个月后,观察组总有效率优于对照组(59.09%vs.29.27%,χ^(2)=10.640,P<0.001)。治疗3个月后,2组血糖指标FPG、2 hPG、HbA_(1c)、HOMA-IR均低于治疗前,GluT4高于治疗前,且观察组上述指标改善程度均显著大于对照组(t/P=2.955/0.004,4.625/<0.001,7.866/<0.001,7.441/<0.001,4.519/<0.001);Pearson相关性分析显示,GluT4与HOMA-IR呈负相关(r=-0.229,P=0.010)。治疗3个月后,2组TC、TG、LDL-C、IL-6、TNF-α、CRP均低于治疗前,HDL-C高于治疗前,且观察组上述指标改善程度均大于对照组(t/P=3.628/<0.001,6.203/<0.001,9.682/<0.001,7.542/<0.001,3.560/<0.001,12.921/<0.001,9.592/<0.001)。2组胃肠道不良反应发生率比较差异无统计学意义(P>0.05);2组均无低血糖发生。结论阿卡波糖联合西格列汀治疗2型糖尿病疗效良好且安全,能够显著改善糖脂代谢紊乱及胰岛素抵抗、调节慢性炎性反应程度。Objective To investigate the effect and possible mechanism of acarbose combined with sitagliptin on glucose and lipid metabolism disorder,insulin resistance and chronic inflammatory response in patients with type 2 diabetes.Methods From June 2016 to June 2020,126 newly diagnosed type 2 diabetes patients diagnosed and treated by the Department of Endocrinology of Ankang Central Hospital were selected,and they were divided into the control group of 82 cases and the observation group of 44 cases according to their medication status.Except for adjusting diet,exercise and other lifestyles,the control group was given acarbose treatment,and the observation group was given acarbose combined with sitagliptin treatment.The blood glucose indicators(FPG,2 hPG,HbA_(1c),GluT4,HOMA-IR),blood lipid indicators(TC,TG,LDL-C,HDL-C)and inflammatory indicators(IL-6,The changes of TNF-αand CRP),the correlation between GluT4 and HOMA IR was analyzed by Pearson correlation,and the clinical efficacy,adverse reactions and safety of the two groups were observed.Results After 3 months of treatment,the total effective rate of the observation group was better than that of the control group(59.09%vs.29.27%,χ^(2)=10.640,P<0.001).After 3 months of treatment,the blood glucose indexes FPG,2 hPG,HbA_(1c),and HOMA-IR of the two groups were all lower than those before treatment,and GluT4 was higher than that before treatment,and the improvement of the above indexes in the observation group was greater than that in the control group(t/P=2.955/0.004,4.625/<0.001,7.866/<0.001,7.441/<0.001,4.519/<0.001).Pearson correlation analysis showed that GluT4 was negatively correlated with HOMA IR(r=-0.229,P=0.010).After 3 months of treatment,TC,TG,LDL-C,IL-6,TNF-αand CRP in both groups were lower than those before treatment,and HDL C was higher than that before treatment,and the improvement of the above indexes in the observation group was greater than that in the control group(t/P=3.628/<0.001,6.203/<0.001,9.682/<0.001,7.542/<0.001,3.560/<0.001,12.921/<0.001,9

关 键 词：2型糖尿病 阿卡波糖 西格列汀 糖脂代谢紊乱 胰岛素抵抗 炎性反应 

分 类 号：R587.1[医药卫生—内分泌]