沙格列汀治疗2型糖尿病的疗效及其对胰岛β细胞功能影响的研究

Therapeutic effects of dipeptidyl peptidase-4 inhibitor saxagliptin on patients with type 2 diabetes and its influences on β-cell function

目的探讨二肽基肽酶-4(DPP-4)抑制剂沙格列汀联合二甲双胍对T2DM的疗效及其对胰岛β细胞功能的影响。方法将75例T2DM患者分为2组,治疗组37例,接受沙格列汀联合二甲双胍治疗,对照组38例,接受格列美脲联合二甲双胍治疗,观察24周,比较两组治疗前后血糖、HbA1c、胰岛素、胰岛素原水平(pro-Ins)等情况。结果两组治疗后FPG、2hPG和HbA1c均较治疗前下降(P<0.05),但两组间比较差异无统计学意义;治疗组治疗后HOMA-β由(37.10±22.70)升至(48.60±26.30),pro-Ins/Ins由(0.43±0.20)降至(0.36±0.19),BMI由(26.70±6.80)kg/m2降至(25.80±5.90)kg/m2,差异均有统计学意义(P均<0.05)。而对照组治疗前后HOMA-β、pro-Ins/Ins及BMI比较差异均无统计学意义。结论沙格列汀在有效降低血糖的同时,不增加体重,且对胰岛β细胞有保护作用。

Objective To explore the effects of dipeptidyl peptidase-4 inhibitor saxagliptin therpy on patients with type 2 diabetes and its influence on β-cell function.Methods The 75 patients with type 2 diabetes were divided into two groups：control group （38 cases）were given glimepiride and metformin,and therapy group （37 cases） were given saxagliptin and metformin for 24 weeks.The changes of FPG,HbA1 c,Ins and proinsulin-to-insulin ratio levels were observed between the two groups before versus after treatment.Results Posttreatment versus pretreatment intra-group showed the levels of FPG,2 hPG and HbA1c were significantly lower （P＜0.05）,but after treatment,there were no significantly differences in FPG,2 hPG and HbA1 c between two groups.The levels of HOMA-β were significant increased from （37.1 ±22.70） to （48.60±26.30）,the proinsulin/insulin ratio were reduced from （0.43±0.20） to （0.36±0.19）and BMI were reduced from （26.70±6.80） kg/m2 to （25.80±5.90） kg/m2 in therapy group （P＜0.05）,but the levels of those in control group had no statistical difference.Conclusion Saxagliptin added to ongoing metformin therapy is efficacious and β-cell function is improved in patients with type 2 diabetes.