西格列汀联合阿卡波糖对2型糖尿病患者肠道相关激素、血脂及葡萄糖转运蛋白4的影响

The therapeutic effect of sitagliptin combined with acarbose on gut related hormones,blood lipids and GLUT4 in patients with type 2 diabetes mellitus

目的观察磷酸西格列汀联合阿卡波糖治疗2型糖尿病对患者肠道相关激素、血脂以及葡萄糖转运蛋白4(GLUT4)的影响。方法选取2014年3月—2016年4月三峡大学人民医院/宜昌市第一人民医院内分泌科诊治2型糖尿病患者198例作为研究对象,采用随机数表法分为对照组(n=98)和观察组(n=100)。对照组给予阿卡波糖治疗,观察组给予磷酸西格列汀联合阿卡波糖治疗。比较患者治疗前、治疗后空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA_(lc))、胃饥饿素、胃泌素、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、GLUT4水平变化,观察记录低血糖、胃肠道反应等不良反应发生情况。结果治疗后,2组患者FPG、2hPG、HbA_(lc)均降低,且观察组明显低于对照组(t=7. 070、3. 443、6. 379,P均=0. 000); 2组患者胃饥饿素、胃泌素等水平均降低,且观察组明显低于对照组(t=20. 843、6. 330,P均=0. 000)。治疗后,2组患者TC、TG、LDL-C水平均降低,HDL-C水平升高,且观察组明显优于对照组(t=7. 975、8. 593、3. 367、9. 661,P=0. 000)。治疗后,2组患者GLUT4水平提高,且观察组明显高于对照组(t=8. 238,P=0. 000)。观察组患者不良反应发生率低于对照组(5. 00%vs. 13. 26%,χ~2=3. 998; P=0. 045)。结论给予2型糖尿病患者磷酸西格列汀联合阿卡波糖治疗,可改善患者的血糖、血脂水平,调节肠道相关激素,提高血清GLUT4水平,降低不良反应发生率,效果显著。

Objective To investigate the effects of type 2 diabetes mellitus on intestinal related hormones,blood lipids and glucose transporter 4(GLUT4)in patients with type 2 diabetes.Methods From March 2014 to April 2016,198 patients with type 2 diabetes mellitus diagnosed and treated in the Department of Endocrinology,the People's Hospital of Three Gorges University/Yichang First People's Hospital were selected as the subjects.The patients were randomly divided into control group(n=98)and observation group(n=100).The control group was given acarbose treatment,and the observation group was treated with the combination of sitagliptin and acarbose.The fasting blood glucose(FPG),postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA lc),gastrin,gastrin,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),and GLUT4 levels were compared before and after treatment.The occurrence of hypoglycemia,gastrointestinal reactions and other adverse reactions were recorded.Results After treatment,FPG,2hPG and HbA lc in the two groups were all decreased,and the observation group was significantly lower than the control group(t=7.070,t=3.443,t=6.379,P=0.000);the levels of gastrin and gastrin in the two groups were all decreased,and the observation group was significantly lower than the control group(t=20.843,t=6.330,P=0.000).After treatment,the levels of TC,TG and LDL-C in the two groups were decreased,while the level of HDL-C in the observation group was higher than that in the control group(t=7.975,t=8.593,t=3.367,t=9.661,P=0.000).After treatment,the levels of GLUT4 in the two groups were significantly higher than those in the control group(t=8.238,P=0.000).The incidence of adverse reactions in the observation group was lower than that in the control group(5.00%vs.13.26%,χ2=3.998;P=0.045).Conclusion Sitagliptin combined with acarbose can improve blood glucose and lipid levels,regulate intestinal hormones,increase serum GLUT4 levels,and reduce the incidence of adverse reactions in patients with type 2 diabetes mellitus.