二肽基肽酶4抑制剂在东亚2型糖尿病患者中的应用与机制探讨

Application and mechanism of dipeptidyl peptidase-4 inhibitor in East Asia type 2 diabetic patients

二肽基肽酶4（DPP-4）抑制剂是一种新型口服降糖药物,通过抑制DPP-4酶活性,提高体内内源性胰升糖素样肽1（GLP-1）水平,增强肠促胰素作用,进而发挥降糖作用.meta分析显示DPP-4抑制剂在东亚2型糖尿病患者中的降糖疗效优于西方2型糖尿病患者,这种疗效上的种族差异可能与东西方糖尿病患者在肠促胰素相关基因的突变频率、β细胞功能障碍程度、GLP-1水平及碳水化合物摄入等方面的差异有关.

Dipeptidyl peptidase 4 （DPP-4） inhibitors are novel oral hypoglycemic agents, which have been used to inhibit degradation of endogenously released glucagon-like peptide-1 （ GLP-1 ） via inhibiting DPP-4 activity, consequently increasing level of GLP-1 in circulation, enhancing the effect of incretin hormone, and finally leading to improve glucose control. Meta-analysis showed that DPP-4 inhibitors exhibit better glucose-lowering effect in Asians compared with that in Caucasian. The racial differences of hypoglycemic effect could be mainly ascribed to the differences in the frequency of pancreatic-related gene mutations, the severity ofβ-cell dysfunction, the level of GLP-1, and the intake of carbohydrates in patients with diabetes mellitus.