甘精胰岛素联合二甲双胍对老年2型糖尿病患者氧化应激的影响

The effects of glargine combined metformin treatment on metabolism of free radicals in elderly patients with type 2 diabetes

目的探讨两种治疗方案对老年2型糖尿病(T2DM)患者体内氧化应激的影响。方法选取90例老年2型糖尿病患者分为两组:甘精胰岛素联合二甲双胍治疗组(A组)、瑞格列奈联合二甲双胍治疗组(B组),每组45例,均接受4周的降糖治疗,选取40例健康者作为对照组。分别测定各组治疗前后空腹血糖(FPG)、餐后2h血糖(2hPG)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-PX)、8-异前列腺素(8-iso-PGF2a)、同型半胱氨酸(Hcy)的值。结果 (1)A、B两组患者的治疗前FPG、2hPG、HbA1c、MDA、8-iso-PGF2a、Hcy均高于对照组,GSH-PX低于对照组,差异具有统计学意义(P<0.05)。(2)A、B组患者治疗后FPG、2hPG、MDA、8-iso-PGF2a、Hcy水平均较治疗前明显降低,GSH-PX水平较治疗前明显升高,差异均具有统计学意义(P<0.05)。(3)A组较B组在降低FPG、2hPG及HbA1c幅度上无明显差异(P>0.05);A组的8-iso-PGF2a、MDA、Hcy较B组下降幅度大,GSH-PX较B组升高幅度大,差异均具有统计学意义(P<0.05)。结论 (1)老年2型糖尿病患者体内存在较高的氧化应激状态;(2)两种治疗方案都能改善老年2型糖尿病患者氧化应激水平,但是甘精胰岛素联合二甲双胍方案在降低老年2型糖尿病患者体内氧化应激方面的作用要优于瑞格列奈联合二甲双胍方案。

Objective To explore the effects of glargine combined metformin and repaglinide combined metformin treatment on metabolism of free radicals in elderly patients with type 2diabetes（T2DM）.Methods Selected 90 cases of elderly T2 DM patients were divided into 2groups：group A（glargine combined metformin treatment group）,group B（repaglinide combined metformin treatment group）.Each group had 45 patients,they were all treated for four weeks in antidiabetic therapy,select 40 healthy people in physical examination center of hospital as controls.They were measured in patients with fasting plasma glucose（FPG）,2h postprandial blood glucose（2hPG）,malondialdehyde（MDA）,glutathione peroxidase（GSH-PX）,8-iso-prostane（8-iso-PGF2a）,Hcy and so on,before and after treatment.Results（1）Before treatment,the FPG,2hPG,HbA1 c,MDA,8-iso-PGF2 a,Hcy of group A and B were higher than the control group,while the level of GSH-PX was lower than the control group,the difference was statistically significant（P〈0.05）;（2）After treatment,the levels of FPG,2hPG,MDA,8-iso-PGF2 a,Hcy were significantly reduced and the levels of GSH-PX was significantly elevated in group A,the differences were statistically significant（P〈0.05）;（3）There were no obvious difference in reduce the levels of FPG,2hPG and HbA1 cbetween group A than group B（P〉0.05）,While 8-iso-PGF2 a,MDA,Hcy of group A had a bigger decline rate than group B,the GSH-PX in group A increased more compared with group B,the difference was statistically significant（P〈0.05）.Conclusion（1）There is a high oxidative stress state in elderly patients with T2DM;（2）Both treatments could improve diabetics oxidative stress levels,but glarginecombined metformin to reduce diabetics oxidative stress is superior to repaglinide combined metformin.