甘精胰岛素联合磷酸西格列汀治疗老年2型糖尿病疗效及其对患者血清RBP4、Nesfatin-1表达的影响

Effects of insulin glargine combined with sitagliptin phosphate on serum RBP4 and Nesfatin-1 expression in elderly type 2 diabetic patients

目的观察甘精胰岛素联合磷酸西格列汀治疗老年2型糖尿病的效果及其对血清视黄醇结合蛋白4(RBP4)、Nesfatin-1表达的影响。方法选择2016年4月—2017年4月大连市中心医院内分泌科收治2型糖尿病患者168例作为研究对象,随机数字表法分为2组,每组84例。对照组患者采用甘精胰岛素注射治疗,观察组患者在对照组基础上口服磷酸西格列汀治疗。治疗12周后比较2组患者血糖控制效果以及血清RBP4、Nesfatin-1水平变化。结果与治疗前比较,治疗后2组患者FPG、2hPG、Hb Alc等血糖指标均降低(P <0. 01),且观察组低于对照组,差异均有统计学意义(t=5. 496、10. 074、10. 511,P <0. 01); 2组TNF-α、CRP、IL-6等炎性因子水平均较治疗前降低(P <0. 01),且观察组低于对照组,差异均有统计学意义(t=7. 265、10. 226、10. 560,P <0. 01); 2组患者血清RBP4、Nesfatin-1水平均降低(P <0. 01),且观察组低于对照组,差异均有统计学意义(t=4. 372、2. 889,P <0. 01)。2组患者均未发生严重并发症,不良反应发生率比较差异无统计学意义(19. 0%vs. 15. 5%,χ~2=0. 384,P=0. 540)。结论采用甘精胰岛素联合磷酸西格列汀能够明显改善机体炎性反应,降低血清RBP4、Nesfatin-1水平,有效控制老年2型糖尿病血糖水平,治疗安全有效,值得在在临床中推广应用。

Objective To investigate the effect of insulin glargine combined with sitagliptin phosphate on type 2 diabetes mellitus and its effect on serum RBP4 and Nesfatin-1 expression.Methods A total of 168 patients with type 2 diabetes mellitus admitted from April 2016 to April 2017 in our hospital were randomly divided into observation group(n=84)and control group(n=84).Patients in the control group were treated with insulin glargine injection.Patients in the observation group were treated with oral sitagliptin phosphate on the basis of the control group.Blood glucose control effect and serum RBP4,Nesfatin-1 levels were compared between the two groups.Results The FPG[(5.3±1.6)vs(6.7±1.7),t=5.496,P=0.000],2hPG[(8.4±1.3)vs(10.5±1.4),t=10.074,P=0.000],HbA lc[(6.3±1.1)vs(7.3±0.9),t=10.511,P=0.000]in observation group were significantly lower than those in control group.Compared with serum TNF-α[(84.83±15.31)vs(102.23±15.73),t=7.265,P=0.000],CRP[(5.87±0.76)vs(7.21±0.93),t=10.226,P=0.000],IL-6[(274.34±25.37)vs(319.47±29.84),t=10.560,P=0.000],RBP4[(8.82±3.84)vs(11.51±4.13),t=4.372,P=0.000],Nesfatin-1[(4.21±1.35)vs(4.83±1.43),t=2.889,P=0.004].The observation group was significantly lower than the control group.There was no significant difference in the incidence of adverse reactions between the two groups(19.0%vs 15.5%,χ2=0.384,P=0.540).Conclusion Glargine and sitagliptin phosphate can significantly improve the body inflammatory response,reduce the levels of RBP4 and Nesfatin-1 and effectively control the blood sugar level of type 2 diabetes mellitus in elderly.The treatment is safe and effective,which is worth popularizing in clinical application.