DPP-4抑制剂西格列汀对2型糖尿病合并肥胖患者血清vaspin水平影响研究

Influence of DPP-4 inhibitor sitagliptin on serum vaspin level in patients with type 2 diabetes mellitus complicating obesity

目的探讨DPP-4抑制剂西格列汀对2型糖尿病(T2DM)合并肥胖患者血清丝氨酸蛋白酶抑制剂(vaspin)、胰岛素抵抗(IR)和胰岛β细胞功能的影响。方法连续性收录肥胖T2DM患者60例,随机分为西格列汀组(n=30)和二甲双胍组(n=30)。分别于入组时和治疗后3月检测血清vaspin水平、IR和胰岛β细胞功能指标。结果经过3个月治疗后,西格列汀组患者稳态模型IR指数(HOMA-IR)、血糖曲线下面积(PGAUC)和vaspin水平显著下降,胰岛β细胞功能指数(HOMA-β)和△I30/△G30水平显著上升。组间比较可见,西格列汀组患者HOMA-IR和vaspin水平显著低于二甲双胍组,而HOMA-β水平显著高于二甲双胍组。西格列汀干预与△HOMA-IR和△vaspin呈负相关,与△HOMA-β呈正相关。结论西格列汀干预治疗可能通过降低血清vaspin水平进而改善肥胖T2DM患者IR和胰岛β细胞功能。

Objective To investigate the influence of DPP-4inhibitor sitagliptin on serum vaspin level,insulin resistance（IR）and beta-cell function in the patients with type 2diabetes mellitus（T2DM）complicating obesity.Methods Sixty T2 DM patients with obesity were consecutively enrolled in this study and randomly divided into the sitagliptin group（n=30）and metformin group（n=30）.The vaspin levels,IR index and beta-cell function in the two groups were measured at grouping and 3months after treatment.Results The HOMA-IR index,PG AUC and vaspin level after 3-month treatment in the sitagliptin group were significantly decreased,while the HOMA-βindex and △I30/△G30level were significantly increased.The intergroup comparison showed that the levels of HOMA-IR and vaspin in the sitagliptin group were significantly lower than those in the metformin group,while the HOMA-βlevel in the sitagliptin group was significantly higher than that in the metformin group.The sitagliptin intervention was negatively correlated with △HOMA-IR and △vaspin,while positively correlated with △HOMA-β.Conclusion The sitagliptin interventional therapy may improve the IR and beta-cell function possibly by reducing serum vaspin level in T2 DM patients with obesity.