烟酰胺对1型糖尿病的防治作用及其机理

Effect of Nicotinamide on Patients with Type-1 Diabetes Mellitus

目的 探讨烟酰胺 (Nicotinamide ,NAA)对 1型糖尿病 (1-DM)的防治作用 方法 NAA 1.2g/m2 .d治疗 1型糖尿病 48例 ,连续口服 4个月 .结果 16例血基础C -肽 (CP)和胰高糖素刺激后 6分钟C -肽 (6’ -CP)显著升高 ;其中 8例出现蜜月期 ,5例胰岛细胞抗体 (ICA)和胰岛素自身抗体 (IAA)均阳性 ,3例为ICA阳性 ;蜜月期发生于治疗后第 3～ 12周 ;随访 18个月 ,其中 5例需恢复INS治疗 .其余的 32例治疗并随访 12个月以上 ,C -肽有上升趋向 .结论 烟酰胺对 1型糖尿病早期的胰岛 β细胞有一定的保护作用 .

Objective To investigate the effect of Nicotinamide on patients with type-1 diabetes mellitus.Methods Forty-eight patients with type 1 diabetes mellitus were treated by nicotinamide 1.2g/m 2 per day for 4 months and the effects were observed up to more than 1 year.Results 16 cases indicated increased basal C-peptide and 6-minute C-peptide after stimulated by glucagon. Among them, 8 cases appeared“honeymoon”period and 6 cases needed less insulin than before.Among the former patients, 5 cases had positive ICA and IAA, 3 cases had positive ICA only.“Honeymoon”period appeared in 3～12 weeks. During 18 months following up, insulin (18～36u/day) was needed again in 5 cases and in other 3 cases it remain unnecessary. C-peptide tended to elevate in the other 32 patients when followed for more than 12 months. In all 48 patients, Lipid and HbA1c decreased significantly.18 cases had increased uric acid and 1 case had flush.Both of them are temporary.Hyperthyroid-like symptom appeared in 1 case and disappeared after dose was reduced.Other side effects were not discovered.Conclutions Nicotnamide has positive effect on the islet β cells of patients with type-1 diabetes mellitus at the intial stage.