维格列汀与西格列汀降糖疗效对比

Comparison of Vildagliptin vs.Sitagliptin:glucose lowering effect

目的:比较维格列汀和西格列汀的降糖效果。方法:受试者随机分配维格列汀组,或者西格列汀组。先后分服两药,使用动态血糖监测(CGM)测定24h的平均血糖、平均血糖波动幅度(MAGE)、空腹血糖、餐后血糖、HbA1c、GA、1,5AG、IRI、CPR、BNP、PAI-1以及尿C肽。结果:维格列汀组的24h平均血糖低于西格列汀组(142.1±35.5vs.153.2±37.0mg/dL;P=0.012)。与西格列汀相比,服用维格列汀的患者,MAGE下降(110.5±33.5vs.129.4±45.1mg/dL;P=0.040),晚餐后血糖峰值也下降(206.1±40.2vs.223.2±43.5mg/dL;P=0.015),早餐后3h内AUC≥180mg/dL也下降(484.3vs.897.9mg/min/dL;P=0.025),尿CPR显著上升(97.0±41.6vs.85.2±39.9μg/day;P=0.008)。两组间HbA1c,GA,1,5AG,IRI,CPR,BNP,或PAI-1均无意义。结论:与西格列汀比较,维格列汀的降糖效果更好,副作用更小,对心血管的保护作用更佳,值得临床推广应用。

Objective:Comparison of Vildagliptin vs.Sitagliptin about glucose lowering effect.Methods:Subjects were randomly assigned to Vildagliptin group,or Sitagliptin group.Taking two drugs respectively,and CGM were used to determine:24-hour blood glucose level,MAGE,fasting blood glucose level,postprandial blood glucose level,HbA1 c,GA,1,5AG,IRI,CPR,BNP,PAI-1and urinary CPR levels.Results:The mean 24-hour blood glucose level was significantly lower in patients taking Vildagliptin than Sitagliptin(142.1±35.5vs.153.2±37.0 mg/dL;P= 0.012).In patients taking Vildagliptin,MAGE was significantly lower(110.5±33.5vs.129.4±45.1mg/dL;P=0.040),the highest blood glucose level after supper was significantly lower(206.1±40.2vs.223.2±43.5mg/dL;P=0.015),the AUC(≥180mg/dL)within3hwas significantly lower after breakfast(484.3vs.897.9mg/min/dL;P=0.025),and urinary CPR level was significantly higher(97.0±41.6vs.85.2±39.9μg/day;P=0.008)than in patients taking Sitagliptin.There were no significant differences in plasma HbA1 c,GA,1,5AG,IRI,CPR,BNP,or PAI-1levels between patients taking Vildagliptin and Sitagliptin.Conclusion:Compared with Sitagliptin,Vildagliptin has better hypoglycemic effect,less side effects,better protective effect on cardiovascular system,worthy of clinical application.