那格列奈和瑞格列奈对2型糖尿病患者血清MDA水平和SOD活性的影响

Comparing the effects between Nateglinide and Repaglinide on the level of serum malondialdehyde and the activity of superoxide dismutase in type 2 diabetics

目的观察那格列奈和瑞格列奈治疗2型糖尿病患者空腹和餐后2h的血清丙二醛(malondialdehyde,MDA)水平以及超氧化物歧化酶(super oxide dismutase,SOD)活性的变化。方法采用随机双盲双模拟阳性对照试验,将46例血糖控制不佳的2型糖尿病患者随机分为两组,分别接受那格列奈(A组)和瑞格列奈(B组)治疗。84d后,比较两种药物对空腹及餐后2h血糖、MDA、SOD、抗氧化比值(AOR=SOD/MDA)以及糖化血红蛋白的影响。结果A组空腹及餐后2h血糖、糖化血红蛋白下降幅度均大于B组,但两者间差异仅空腹血糖具有统计学意义(P=0.033)。两种药物均可显著降低餐后MDA水平(P<0.01),平均下降值分别为2.57、1.58nmol·ml-1,两组下降幅度差异无统计学意义。瑞格列奈对空腹AOR、那格列奈对餐后AOR均有显著提高,P分别为0.031和0.006。结论那格列奈和瑞格列奈具有抑制2型糖尿病患者氧化应激的作用,可能有助于预防或延缓糖尿病慢性并发症的发生和发展。

OBJECTIVE To evaluate and compare the effects between Nateglinide and Repaglinide on fasting and postprandial malondialdehyde and superoxide dismutase in type 2 diabetics. METHODS A randomized controlled double - blind and double - dummy clinical trial was eanducted. 46 Chinese type 2 diabetic patients who had poor glycemic control were randomized to receive either Nateglinide or Repaglinide for 84 days. Fasting and 2 - hour postprandial blood glucose, HbAle, MDA level and SOD activity were measured, and anti - oxide ratio （ AOR = SOD/MDA） was calculated. RESULTS Compared with Nateglinide group, there was a greater reduction in fasting blood glucose, 2 - hour postprandial blood glucose and HbAlc in Repaglinide group. Significant difference was found between Nateglinide group and Repaglinide group in fasting blood glucose only （ P = 0. 033 ）. 2 - hour postprandial MDA values decreased significantly in both Nateglinide and Repaglinide groups （P 〈 0.01 ）. Fasting AOR increased significantly in Repaglinide group （P = 0. 031 ） and postprandial AOR increased significantly in Nateglinide group （P = 0.006）. CONCLUSION Our study suggests that both Nateglinide and Repaglinide have favorable effects on oxida- tive stress status in type 2 diabetie patients. Theses effects can offer additional benefits to type 2 diabetic patients and may postpone chronic dialytic complications.