瑞格列奈和格列吡嗪对初发2型糖尿病氧化应激的影响

Effects of repaglinide and glipizide on oxidative stress in the early stage of type 2 diabetes

目的探讨瑞格列奈和格列吡嗪对初发2型糖尿病氧化应激的影响。方法60例初发2型糖尿病患者随机分为瑞格列奈组(30例)及格列吡嗪组(30例),服用12周后,比较治疗前后两组患者空腹及餐后2 h血糖(FBG,2 h PG)、餐后1 h及2 h胰岛素(1 h Ins,2 h Ins)、糖化血红蛋白(HbA1c)及氧化应激相关指标的变化。结果两组治疗后FBG及2 h PG、HbA1c均明显下降(均P<0.05)。与格列吡嗪组比较,瑞格列奈组2 h PG明显下降(P<0.05),1 h Ins明显升高(P<0.05)。格列吡嗪组治疗后2 hIns较治疗前明显升高(P<0.05),而瑞格列奈组无明显变化。瑞格列奈组治疗后超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)活性明显上升,丙二醛(MDA)水平显著下降(均P<0.01),而格列吡嗪组无明显变化。结论瑞格列奈可改善胰岛素早期分泌时相,更好地控制餐后血糖,并具有抗氧化能力,通过抑制氧化应激反应而对T2DM患者有额外的益处。

Objective To investigate the influence of repaglinide and glipizide on oxidative stress in the early stage of type 2 diabetes. Methods Sixty patients with type 2 diabetes were randomly divided into two groups as repaglinide group （ n = 30） and glipizide group （ n = 30）, 12 weeks later, the changes of the fasting blood glucose （FBG） and 2-hour post-prandial blood glucose （ 2 h PG ） , 1-hour and 2-hour plasmie insulin （1 h Ins, 2 h Ins）, HbAlc levels, malondialdehyde （MDA）, the activity of antioxidant enzymes including superoxide dismutase （SOD）, and glutathione peroxidase （GSH-Px） were compared with the baseline. Results After treatment, in both groups, the FBG,2 h PG and HbA1 c were lowered than before treatment（P 〈 0.05 ）. 2 h PG were decreased significantly, while 1 h Ins increased significantly in repaglinide group than that in glipizide group （ P 〈 0.05 ）. Compared with before treatment, glipizide group showed a significant increase of 2 h Ins, but repaglinide group had no significant difference. The activity of SOD and GSH-Px were increased significantly respectively （ P 〈 0.01, P 〈 0.05 ）, while the contents of MDA decreased significantly （ P 〈 0.05 ） in repaglinide group after treatment, but were not altered in glipizide group. Conclusion the early insulin release, and postprandial glucose may be better controlled. The repaglinide may offer an additional benefit to type 2 diabetes.