摘要
目的:探讨吡格列酮、胰岛素治疗对初诊2型糖尿病患者血尿酸与1,5-脱水葡萄糖醇(1,5-AG)的影响。方法:选取初诊2型糖尿病合并高尿酸血症患者70例,随机分为吡格列酮组(34例)和胰岛素组(36例)。治疗3个月,比较两组治疗前后空腹血糖(FPG)、糖化血红蛋白(HbA1c)、1,5-AG、血尿酸水平变化。结果;两组患者治疗后FPG、HbA1c、血尿酸较治疗前下降,而1,5-AG较治疗前上升(P<0.01)。胰岛素组治疗后FPG、HbA1c低于吡格列酮组,1,5-AG、血尿酸高于吡格列酮组(P<0.01)。吡格列酮组降低血尿酸作用比胰岛素组更显著(P<0.01),胰岛素组升高1,5-AG作用比吡格列酮组更显著(P<0.01)。两组治疗前后1,5-AG与FPG均呈显著负相关(r=-0.774,P<0.01;r=-0.582,P<0.01),(r=-0.800,P<0.01;r=-0.586,P<0.01);1,5-AG与血尿酸无相关性(P>0.05)。结论:吡格列酮可使血尿酸水平显著降低。胰岛素降低血糖,进而导致1,5-AG水平显著升高。
Objective: To investigate the effects of pioglitazone or insulin on serum uric acid and 1,5-anhydroglucitol in new-onset type-2 diabetics Methods: Seventy new-onset type-2 diabetics with hyperuricemia had been selected and had randomly divided into 2 groups,one group treated with pioglitazone( n = 34) and the other group with insulin( n = 36). Fasting plasma glucose( FPG),glycosylated hemoglobin( HbA 1c),1,5-anhydroglucitol and serum uric acid had been compared before and after 3-month treatment. Results: FPG,Hb A1 c and serum uric acid decreased significantly and 1,5-anhydroglucitol increased significantly in both the groups after 3 months treatment,the differences being statistically significant( P<0. 01). FPG and Hb A1 c in the insulin group were lower than those in the pioglitazone group,but 1,5-anhydroglucitol and serum uric acid higher( P<0. 01). The serum uric acid in the pioglitazone group decreased more than the insulin group( P<0. 01); the 1,5-anhydroglucitol in the insulin group increased more than the pioglitazone group( P<0. 01). There existed a significant negative correlation between 1,5-AG and FPG in both the groups before and after 3months treatment( r =-0. 774,P < 0. 01; r =- 0. 582,P < 0. 01),( r =- 0. 800,P < 0. 01; r =- 0. 586,P <0. 01); there was no correlation between 1,5-AG and serum uric acid( P>0. 05). Conclusion: Pioglitazone can lead to a decrease in serum uric acid,while Insulin can lead to a decrease in blood glucose,and then can significantly increase the level of 1,5-anhydroglucitol.
