罗格列酮对老年2型糖尿病患者胰岛β细胞功能影响

Effect of rosiglitazone on β-cell function in elderly patients with type 2 diabetes mellitus

目的观察罗格列酮对磺脲类降糖药继发性失效(SF)的老年2型糖尿病(T2DM)患者的胰岛β细胞功能影响。方法选择69例SF的T2DM患者,根据年龄分为老年组(≥60岁,37例)、中青年组(<60岁,32例),分别加用罗格列酮或胰岛素治疗24周,治疗前后分别测糖化血红蛋白(HbA1c)、空腹血糖(FBG)、空腹胰岛素(FIns)、血脂、稳态模型的胰岛素抵抗指数(HOMA-IR)、HOMAβ胰岛细胞分泌指数(HOMA-IS),胰岛素敏感指数(ISI)、糖负荷30min净增胰岛素/净增血糖比值(ΔI30/ΔG30)并进行比较。结果治疗后各组HbA1c、FBG、HOMA-IR均明显下降,HOMA-IS、ISI均明显升高,差异有统计学意义(P<0.01),治疗后罗格列酮组FIns较治疗前有所升高(P<0.05),而胰岛素组无明显变化,治疗后各组ΔI30/ΔG30均较治疗前升高(P<0.05或P<0.01)。结论本研究表明罗格列酮有助于诱导β细胞功能的恢复,这种作用对老年患者同样有效。

Objective To observe the effect of rosiglitazone on β-cell function in elderly patients with type-2 diabetes meUitus with secondary failure to sulfonylurea. Methods Sixty-nine cases of type-2 diabetes mellitus with secondary failure to sulfonylurea were enrolled and divided into old age group（ ≥60 years old,37 cases） ;middle age and youth group （ 〈60 years old,32 cases）. All patients received rosiglitazone or insulin for treatment for 24 weeks. HbA1c,FBG,FIns, TG, HDL-C,TC, LDL-C, HOMA-IR, HOMA-IS, ISI, △I30/△G30 were checked before,during and after the treatment in two groups. Results HbA1c, FBG, HOMA-IR decreased but HOMA-IS, ISI, increased after treament in each group （P 〈 0. 01 ） ,while Fins increased in groups treated with rosiglitazone（ P 〈0.05 ） but had no change in groups which received insulin. Conclusions Rosiglitazone could induce the β-cell function to recover, and it has equal effects for elderly patients.