西格列汀对合并2型糖尿病的代谢综合征患者代谢指标及颈动脉内中膜厚度的影响

The inspection of sitagliptin to metabolic index and carotid artery IMT in metabolic syndrome patients with type 2 diabetes

目的探讨西格列汀对合并2型糖尿病的代谢综合征患者的血糖、血压、血脂等代谢指标及颈动脉内中膜厚度的影响。方法纳入本院自2012年2月至2013年8月的住院及门诊的合并有2型糖尿病的代谢综合征患者64例，包括未使用任何降糖药物和仅使用稳定剂量的二甲双胍降糖的患者，签署知情同意后，随机分为西格列汀组及维持原治疗方案组，比较用药24周后的代谢指标及颈动脉内中膜厚度的变化。结果两组在基线状态时的BMI，腰围（WC），空腹血糖（FPG），TG，HDL-C，SBP，DBP，HbA1c以及颈动脉内中膜厚度（IMT）差异均无统计学意义（P〉0．05）。随访12周时西格列汀组的FPG，TG，DBP，HbA1c明显优于对照组及其自身的基线状态（P〈0．05），其他代谢指标两组之间及前后对比差异均无统计学意义（P〉0．05）；随访24周时西格列汀组FPG，TG，HDL，C，DBP，HbA1c及颈动脉IMT亦明显优于对照组及其自身的基线状态（P〈0．05）。结论西格列汀除有效地降低血糖外，还有降低血压，调节血脂，保护血管内皮的功能。

Objective To evaluate the effects of sitagliptin on blood glucose, blood pressure, blood lip and carotid artery intima media thickness （IMT） in metabolic syndrome patients with type 2 diabe- tes. Methods The clinical data were collected for 64 cases of inpatient and outpatient patients with meta- bolic syndrome with type 2 diabetes. Those patients included anti-diabetes native patients and patients only used the stable mefformin dose. After signed off the informed consent form, those patients were randomized to the sitagliptin treatment group or original treatment group, and the metabolic index and carotid artery intima-media thickness were evaluated after 24 weeks treatment. Results The body mass index （BMI） , waist circumference （WC）, fasting plasma glucose （FPG） , triglycerides （TG）, high density lipoprotein choles- terol （HDL-C）, systolic blood pressure （SBP） , diastolic blood pressure （DBP）, glycated hemoglobin ale （HbAIc）, and carotid artery IMT in two groups were comparable at baseline. After 12 weeks treatment, the FPG, TG, DBP, and HbA1c in the sitagliptin group were significantly better than original treatment group and the baseline, while there was no different between two groups in other index. After 24 weeks treatment, the FPG, TG, HDL-C, DBP, HbAlc, and carotid artery IMT in the sitagliptin group were sig-nificantly better than original treatment group and the baseline. Conclusions Sitagliptin presents the functions of lowering blood pressure, adjusting blood lipid, and protecting vascular endothelial in addition to lowering blood glucose.