二甲双胍和格列吡嗪对2型糖尿病患者血清分泌型卷曲相关蛋白5水平的影响研究

Study on the Effect of Metformin and Glipizide on the Serum SFRP5 in Patients with Type 2 Diabetes Mellitus

目的探讨二甲双胍和格列吡嗪对2型糖尿病患者血清分泌型卷曲相关蛋白5(SFRP5)水平的影响。方法选择2012年7月—2013年9月三峡大学仁和医院体检中心体检健康者45例为对照组。同时期我院门诊、内分泌科住院的1年内新诊断的2型糖尿病患者93例,根据治疗不同分为两组:二甲双胍组47例、格列吡嗪组46例。观察3组治疗前,二甲双胍组及格列吡嗪组治疗后血压、体质指数(BMI)、稳态模型胰岛素抵抗指数(HOMA-IR)、空腹血糖(FPG)、血脂、糖化血红蛋白(HbA1c)、胰岛素、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)、SFRP5水平变化。结果治疗前二甲双胍组和格列吡嗪组较对照组HOMA-IR、FPG、三酰甘油(TG)、血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、胰岛素、HbA1c、IL-6、TNF-α水平升高,高密度脂蛋白胆固醇(HDLC)、SFRP5水平降低(P<0.05)。治疗后格列吡嗪组较二甲双胍组HOMA-IR、TG、胰岛素、TNF-α水平升高,SFRP5水平降低(P<0.05)。血清SFRP5水平与BMI、HOMA-IR、FPG、TG、HbA1c、胰岛素、IL-6、TNF-α均呈负相关(P<0.05);与HDL-C呈正相关(P<0.05)。多元逐步回归结果显示HOMA-IR、BMI是影响SFRP5水平的独立相关因素(P<0.05)。回归方程为SFRP5=-0.178×HOMA-IR-0.076×BMI+4.521。结论 2型糖尿病患者血清SFRP5水平降低,二甲双胍、格列吡嗪改善2型糖尿病患者胰岛素抵抗、糖代谢的同时升高SFRP5水平,二甲双胍对SFRP5水平的升高更明显。

Objective To investigate the effects of mefformin and glipizide on serum secreted frizzled - related protein -5 （SFRPS） level in patients with type 2 diabetes mellitus （T2DM） . Methods 45 normal subjects from 2012 July to 2013 September in the Renhe Hospital of China Three Gorges University were selected as the control group. 93 patients with newly - di- agnosed T2DM were according to different treatments, divided into two groups： Metformin treated group （n = 47 ）, Glipizide trea- ted group （n =46） . Before and after treatment the levels of BMI, HOMA -IR, FPG, Blood lipid, HbAlc, Insulin, IL -6, TNF - ct, SFRP5 were observed. Results Before treatment, the level of HOMA - IR, FPG, TG, TC, LDL - C, insulin, HbAIo, IL - 6, TNF - c~ in T2DM group were significantly higher than those in the control group, while the HDL - C, SFRP5 level were lower, the differences were significant （ P 〈 O. 05 ） . After treatment, HOMA - IR, TG, insulin and TNF - ~t levels increased and SFRP5 level decreased in Glipizide treated group than those in Metformin treated group （ P 〈 0. 05 ） . Correlation a- nalysis showed that SFRP5 level was negatively correlated with BMI, HOMA -IR, FPG, TG, HbA^c, Insulin, IL- 6, TNF - o~ （ P 〈 0. 05 ）, and positively correlated with HDL - C （ P 〈 0. 05 ） . Ultiple regression analysis showed that HOMA - IR and BMI were independently related factors influencing serum SFRP5 levels （ P 〈 0. 05 ） . The regression equation is SFRP5 = -0. 178 x HOMA - IR - 0. 076 x BMI ＋ 4. 521. Conclusion The serum SFRP5 level tends to decrease in patients with T＇2DM. Metformin, Glipizide can improve insulin resistance, glycometablism and at the same time elevate serum SFRP5 level, es- pecially Metformin.