阿卡波糖对2型糖尿病患者血清nesfatin-1水平及糖脂代谢的影响

Effects of acarbose on the plasma nesfatin-1,glucose and lipid metabolism in patients with type 2 diabetes mellitus

目的评估阿卡波糖对2型糖尿病患者血清nesfatin-1水平及糖、脂代谢的影响。方法对符合纳入标准的60例2型糖尿病患者进行原降糖药物调整,当空腹血糖(FPG)、餐后2 h血糖(2hPG)分别控制在6～8、8～10 mmol/L后,将所有患者随机分为2组:试验组在原降糖方案基础上给予阿卡波糖片,对照组进行空白对照。试验周期12周。结果试验组与对照组基线水平差异无统计学意义(P>0.05)。试验组治疗前后nesfatin-1水平上升(P<0.01),FPG、2hPG、糖化血红蛋白(HbA1c)、体质量指数(BMI)、稳态模型胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)及总胆固醇(TC)均较前降低(P<0.01或P<0.05),对照组仅2hPG较前下降(P<0.01)。治疗后行协方差分析结果显示,试验组nesfatin-1水平较对照组升高(P<0.05),FPG、2hPG、HbA1c、空腹胰岛素(FPI)、HOMA-IR、TG及TC均较对照组降低(P<0.05或P<0.01)。结论阿卡波糖可升高2型糖尿病患者血清nesfatin-1水平,并有效改善糖脂代谢。

Objective To investigate the effect of acarbose on the plasma nesfatin-1, glucose and lipid metabolism in patients with type 2 diabetes mellitus. Methods 60 patients who met the inclusion criteria were selected. After dose adjustment for previous oral hypoglycemic, the fasting plasma glucose （ FPG）, 2-hour postprandial blood glucose （2hPG） of them reached 6-8 mmol/L, 8-10 mmol/L respectively. Then all of the patients were randomized into two groups. One group receive acarbose on the base of the initial hypoglycemic as the test group, and the other acted as the blank control group. The study lasted for 12 weeks. Results There was no statistically significant between the two groups at baseline （P 〉 0.05 ）. After 12-week treatment, the plasma nesfatin-1 level in the test group was significantly higher than before（ P 〈 0.01 ）, but there was no significant change in the control group. FPG, 2hPG, glycosylated hemoglobin （ HbA 1 c）, body mass index （ BMI）, homeostasis model assessment of insulin resistance （ HOMA-IR）, triglyceride （TG） and total cholesterol（TC） were all reduced obviously in the test group （P 〈 0.01 or P 〈 0.05 ）. Only 2hPG decreased in the control group（ P 〈 0.01 ）. Covariance analysis demonstrated that after treatment, the level of nesfatin-1 was higher in the test group compared with that in the control group（P 〈0.05）, FPG, 2hPG, HbAlc, fasting plasma insulin （ FPI）, HOMA-IR, TG and TC were significant lower in the test group （ P 〈 0.01 or P 〈 0.05 ）. Conclusion Acarbose is an effective medicine for increasing the level of plasma nesfatin-land improving glucose and lipid metabolism in patients with type 2 diabetes melIitus.