沙格列汀对糖尿病肾病尿微量白蛋白的影响

Effect of Saxagliptin on Urinary Albumin in Patients with Diabetic Nephropathy

目的观察沙格列汀对糖尿病肾病尿微量白蛋白的影响及可能机制。方法将48例单用胰岛素、血糖控制不理想的糖尿病肾病患者随机分成胰岛素联合沙格列汀组(A组)和单用胰岛素组(B组),观察治疗前、治疗后12周两组患者的体重指数(BMI)、空腹血糖(FBG)、餐后2h血糖(2h PG)、糖化血红蛋白(Hb A1c)、胰岛素用量、尿微量白蛋白、高敏C反应蛋白(hs-CRP)的变化。结果治疗12周后,两组FBG、2h PG、Hb A1c水平均较治疗前降低(P<0.05),但两组比较无明显差异(P>0.05);A组较治疗前体重增加不明显(P>0.05),胰岛素用量、尿微量白蛋白及hs-CRP水平明显降低(P<0.05),而B组较治疗前BMI及胰岛素用量增加(P<0.05),尿微量白蛋白及hs-CRP水平无明显变化(P>0.05)。结论沙格列汀可以降低糖尿病肾病患者尿微量白蛋白水平,可能与其改善机体炎症状态有关。

Objective This study was aimed to investigate the effect and possible mechanism of saxagliptin on urinary albumin in patients with diabetic nephropathy. Methods 48 patients with diabetic nephropathy were randomly divided into two groups： group A（ saxagliptin-insulin combination therapy group） and group B（ insulin mono-therapy group）. The body mass index（ BMI）,fasting blood glucose（ FBG）,postprandial blood glucose（ 2h PG）,glycosylated hemoglobin（ Hb A1c）,the dose of insulin,urinary albumin and hypersensitive creactive protein（ hs-CRP） were tested before and after treatment for 12 weeks. Results After 12 weeks of treatment,the levels of FBG,2h PG and Hb A1 c in the two groups were lower than those before treatment（ P 〈0. 05）. These parameters had no significant difference between group A and group B（ P 〉 0. 05）. The amount of insulin,urinary albumin and hs-CRP were decreased in group A after treatment（ P 〈 0. 05）. BMI had no significant difference between before and after treatment in group A（ P 〉 0. 05）. But BMI and the amount of insulin were increased in group B after treatment（ P 〈 0. 05）. Urinary albumin and hs-CRP had no significant difference between before and after treatment in group B（ P 〉 0. 05）. Conclusion Saxagliptin can reduce urinary albumin in patients with diabetic nephropathy possiblely via improving inflammative state in organism.