西格列汀联合大剂量胰岛素对非胰岛素依赖型糖尿病患者血清miR-342-5p和miR-423-5p表达的影响

Analysis of effect of sitagliptin combined with large dose of insulin on the expression of miR-342-5p and miR-423-5p in serum of patients with noninsulin-dependent diabetes mellitus

目的分析西格列汀联合大剂量胰岛素对非胰岛素依赖型糖尿病患者血清miR-342-5p和miR-423-5p表达的影响,探讨该治疗方案对患者微血管并发症的预防机制。方法选取我院2012年6月-2014年6月收治的182例非胰岛素依赖型糖尿病患者,按照随机数字表分为观察组及对照组,各91例,均给予大剂量胰岛素治疗。观察组在此基础上加用西格列汀。比较2组患者疗程结束后血清miR-342-5p和miR-423-5p表达的变化。结果 2组患者治疗后FBG、2h PG、Hb A1c均显著降低,观察组降低更为明显(P<0.05)。观察组治疗后胰岛素用量显著降低(P<0.05),对照组未见明显变化(P>0.05)。治疗前后2组患者BMI均未见明显变化(P>0.05)。观察组、对照组患者治疗期间低血糖反应发生率分别为14.3%、16.5%,差异未见明显统计学意义(P>0.05)。2组患者治疗后TC、LDL-C水平均未见明显变化。对照组患者治疗前后TG水平也未见明显变化(P>0.05),治疗后HDL-C显著降低(P<0.05);观察组患者治疗后TG显著降低,HDL-C显著升高。观察组患者治疗后miR-342-5p和miR-423-5p表达水平均显著降低,对照组患者治疗后上述指标表达水平显著升高(P<0.05)。结论西格列汀联合大剂量胰岛素能够有效降低非胰岛素依赖型糖尿病患者血清miR-342-5p和miR-423-5p表达水平,对其微血管并发症的预防具有重要意义,具有确切的疗效及良好的安全性,值得进一步深入研究。

AIM To analyze the efficacy of the expression of miR-342-5p and miR-423-5p in noninsulin-depen- dent diabetes mellitus patients who were treated with large dose of insulin combined with sitagliptin, and to investigate the treatment for the prevention effect to the patients of mierovascular complications. METHODS Totally 182 patients with noninsulin-dependent diabetes mellitus were selected in our hospital from June 2012 - June 2014, and were randomly di- vided into observation group and control group, with 91 patients in each group. All patients were given large doses of in- sulin therapy, and the observation group was added with use of sitagliptin. All of them were measured miR-342-5p and miR-423-5p before and after treatment. RESULTS For 2 groups of patients after treatment, FBG, 2hPG and HbAlc were significantly decreased, 2hPG, HbAlc decreased significantly in the observation group （P 〈 0.05） ; in the observa- tion group after treatment dosage of insulin decreased significantly （ P 〈 0.05）, in the control group there was no obvious change （ P 〉 0.05） ; after treatment in 2 groups there were not found in BMI significant changes （ P 〉 0.05）. After treatment, the incidence of hypoglycemia was 14.3 % and 16.5 %, respectively （ P 〉 0.05）. The patients in the 2 groups after treatment TC, LDL-C level had no significant change, and in the control group TG levels before and after treatmenthad no obvious change （P 〉 0.05）; patients in the observation group after treatment, TG decreased, HDL-C increased significantly, patients in the control group after treatment HDL-C was significantly decreased （ P 〈 0.05）. Patients in the observation group after treatment, miR-342-5p and miR-423-5p expression levels were significantly decreased after treat- ment, patients in the control group the index expression levels significantly increased （ P 〈 0.05）. CONCLUSION Pa- tients who treated with large dose of insulin combined with sitagliptin can effectively reduce the serum levels of miR-342- 5p and miR-423-5p expression level, which has the vital significance to prevent the microvascular complications, and has the exact curative effect and good safety, and is worthy to be further study.