西格列汀干预成人隐匿性自身免疫糖尿病患者的血管保护作用及机制  

Effect and mechanism of sitagliptin on vascular protection in latent autoimmune diabetes in adults

作　　者：王丹萍[1] 韩坤[2] 王朝旭 沈亚非[1] 邓飞[1] WANG Dan-ping;HAN Kun;WANG Zhao-xu;SHEN Ya-fei;DENG Fei(Department of Endocrinology,LuoHe Central Hospital,the 1st Affiliated Hospital of LuoHe Medical College,Luohe,Henan 462002,China;Department of Physiology,Luohe Medical Colloge,Luohe,Henan 462002,China)

机构地区：[1]漯河市中心医院,漯河医学高等专科学校第一附属医院内分泌代谢科,河南漯河462002 [2]漯河医学高等专科学校生理教研室,河南漯河462002

出　　处：《医药论坛杂志》2022年第23期16-20,共5页Journal of Medical Forum

基　　金：河南省重点研发与推广专项(科技攻关)(212102310798);河南省医学科技攻关计划联合共建项目(LHGJ20210955);漯河医专高等专科学校创新创业发展能力提升工程(2020-LYZKYXM008)。

摘　　要：目的研究西格列汀对预成人隐匿性自身免疫糖尿病(latent autoimmune diabetes in adults,LADA)患者的血糖、胰岛功能及血管病变的影响。方法收集2019年1月至2021年12月就诊于漯河市中心医院内分泌科门诊及病房,应用胰岛素强化治疗方案的LADA患者32例,按照1∶1比例随机分为:对照组(n=16),治疗组(在胰岛素应用的基础上,加用西格列汀,n=16),比较两组患者FBG及2 h PG、空腹C肽及餐后2小时C肽水平、HbA1C、miRNA-126的表达量及eNOS水平。结果两组患者中,治疗后治疗组餐后2 h C肽水平(1.02±0.22)ng/mL,明显高于对照组(0.68±0.19)ng/mL,差异有统计学意义(P<0.05)。治疗组治疗后miRNA-126的表达量较治疗前增加,治疗组治疗后eNOS水平(483.23±22.79)pg/mL较治疗前(256.01±21.56)pg/mL增加,差异均有统计学意义(P<0.05)。结论西格列汀用于LADA早期患者的治疗,除了更好的血糖控制及胰岛保护作用以外,还可能通过调节miRNA-126和eNOS的表达而在LADA患者的血管并发症中获益。Objective To study the effects of Sitagliptin on blood glucose,islet function and vascular complication in latent autoimmune diabetes in adults.Methods A total of 32 LADA patients who received intensive insulin therapy in outpatient and ward of endocrinology department of our hospital from January 2019 to December 2021 were collected.Thirty-two LADA patients were randomly divided into control group(n=16)and treatment group(Sitagliptin was concomitant with insulin,n=16).FBG(fasting blood-glucose)and 2hPG(2-hour postprandial blood glucose),fasting C-peptide and C peptide 2 hours postprandial,HbA1C,expression levels of miRNA-126 and eNOS of the two groups were compared.Results In the two groups,the level of 2h C-peptide in the treatment group(1.02±0.22)ng/mL was significantly higher than that in the control group(0.68±0.19)ng/mL,the difference was statistically significant(P<0.05).Compared to before treatment,the expression level of miRNA-126 and eNOS(483.23±22.79 vs 256.01±21.56)pg/mL of the treatment group were increased,and the differences were statistically significant(P<0.05).Conclusion In addition to better blood glucose control and islet protection,Sitagliptin may also improve vascular complications in early LADA patients by regulating mirNA-126 and eNOS expression.

关 键 词：成人隐匿性自身免疫糖尿病 西格列汀 miRNA-126 一氧化氮合成酶 

分 类 号：R587.1[医药卫生—内分泌]