罗格列酮对2型糖尿病的降糖效果和胰岛β细胞功能变化观察

The Effect of Rosiglitazone on Glycemia and β-Cell Function in Type 2 Diabetic Patients

目的 观察罗格列酮 (文迪雅 )对 2型糖尿病的降糖效果和胰岛素 β细胞功能、胰岛素敏感性的影响及药物副作用。方法 开放性、自身前后对照试验 ,3 1例 2型糖尿病 ,分为单用文迪雅 (n =13 )、文迪雅加二甲双胍 (n =9)、文迪雅加磺酰脲类 (n=9)。观察时间 12周 ,观察 :体重、体重指数 (BMI)、空腹血糖 (FBG)、血脂、血压、肝功能、空腹胰岛素 (FINS) ,用HOMA方法评估胰岛 β细胞功能 (HOMA -β)和胰岛素抵抗指数 (HOMA -IR)。 结果 治疗前FBG(8 89± 2 49)mmol/L ,FINS(17 89± 5 78)mU/L ,HOMA-β 79 75± 41 2 8(自然对数值 4 2 5± 0 5 3 ) ,HOMA -IR 7 15± 3 40 (自然对数值 1 87± 0 43 ) ,治疗后FBG(7 2 7± 2 2 6)mmol/L ,FINS(14 3 3± 3 82 )mU/L ,HOMA -β 12 0 84± 14 0 66(自然对数值 4 5 0± 0 72 ) ,HOMA -IR 4 63± 1 81(自然对数值 1 45± 0 41) ,上述指标治疗前后比较差异均有显著性 (P <0 0 0 1) ;治疗前后体重、BMI、谷草转氨酶、总胆红素、总胆固醇均无统计学差异 ,甘油三酯、高密度脂蛋白、低密度脂蛋白治疗后增加 (P <0 0 5 ) ,收缩压、舒张压治疗后下降 (P <0 0 5 ) ,谷丙转氨酶治疗前 (2 6 91± 11 66)U/L ,治疗后 (2 1 2 7± 11 98)U/L ,两者之间比较P

Objective To investigate the effects of rosiglitazone (RSG) on glycemia and β-cell function in type 2 diabetic patients. Mothods Open-label and self-match trial was carried out. 31 cases of type 2 diabetic patients were divided into RSG monotherapy group (n=13), RSG plus metformin group (n=9), and RSG plus sulphonylureas group. All the patients received treatment for 12 weeks. Weight, body mass index, FBG, FINS, blood pressure, TG, Tch, HDL, LDL, ALT, AST and TBIL were determined before and after therapy. The insulin resistance (HOMA-IR) and β-cell function (HOMA-β) of the patients were evaluated using homeostasis model assessment (HOMA). Results Compared with before treatment, there was a significant improvement in FBG, FINS, HOMA-β and HOMA-IR in all the patients after treatment (FBG 8.89±2.49mmol/L, FINS 17.89±5.78mU/L, HOMA-β 79.75±41.28,HOMA-IR 7.15±3.40 vs FBG 7.27±2.26mmol/L, FINS 14.33±3.82mU/L,HOMA-β 120.84±140.66,HOMA-IR 4.63±1.81, respectively,P<0.001). No significant change in weight, body BMI, AST, TBIL, and Tch after theray compared with before therapy. The levels of TG, HDL and LDL increased after RSG therapy(P<0.05). Both the systolic pressure and diastolic pressure decreased after RSG therapy (P<0.05). ALT level decreased after RSG therapy compared with before therapy (21.27±11.98U/L vs 26.91±11.66U/L). There were no significant side-effects during RSG treatment. Conclusion Rosiglitazion is effective for the patients with type 2 diabetes. It could decrease insulin resistance and improve β-cell function, and there were not obvious side-effects during RSG treatment.