吡格列酮在改善2型糖尿病患者胰岛B细胞功能中的作用

The Role of Pioglitazone in Improving the Function of Islet B Cells in Patients with Type 2 Diabetes Mellitus

目的探讨吡格列酮在改善2型糖尿病(T2DM)患者胰岛B细胞功能中的作用。方法将深圳市大鹏新区妇幼保健院2016年11月至2018年8月收治的62例初发T2DM患者随机分为两组,其中对照组(n=31)仅用常规治疗,而试验组(n=31)予以常规治疗+吡格列酮治疗,比较两组的疗效及对患者胰岛B细胞功能的影响。结果两组治疗前糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2hPBG)比较,差异无统计学意义(P>0.05),而两组治疗后的HbA1c、FPG、2hPBG均低于治疗前,且试验组HbA1c、FPG、2hPBG均低于对照组,差异有统计学意义(P<0.05);两组治疗前胰岛素抵抗指数(HOMA-IR)、胰岛B细胞功能指数(HOMA-B)比较,差异无统计学意义(P>0.05),而治疗后两组的HOMA-IR、HOMA-B均优于治疗前,且试验组均优于对照组,差异有统计学意义(P<0.05);两组治疗前三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)比较,差异无统计学意义(P>0.05),而两组治疗后TG、TC、LDL-C、HDL-C均优于治疗前,且试验组优于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论吡格列酮可辅助医治T2DM,增加患者胰岛B细胞敏感性。

Objective To explore the role of pioglitazone in improving the function of islet β cells in patients with type 2 diabetes mellitus(T2 DM). Methods A total of 62 patients with initial T2 DM admitted by Shenzhen Dapeng New District Maternal and Child Health Hospital from November 2016 to August 2018 were randomly divided into 2 groups. The control group(n=31) was treated with conventional therapy only, while the experimental group(n=31) was treated with conventional therapy + pioglitazone. The effects of the 2 groups and the effects on the β cell function of the patients were compared. Results The differences among HbA1 c(glycated hemoglobin), FPG(fasting blood glucose), 2 hPG(2 h postprandial blood glucose) of the 2 groups before treatment were not statistically significant(P>0.05), while after treatment, the HbA1 c, FPG and 2 hPBG of the 2 groups were lower than those before treatment, and the HbA1 c, FPG and 2 hPBG of the experimental group were lower than the control group.(P<0.05);the pre-treatment insulin resistance index of the 2 groups( HOMA-IR and islet B cell function index(HOMA-B) were not significantly different(P>0.05), and HOMA-IR and HOMA-β were better than those before treatment, and the experimental group was better than the control group.(P<0.05);There were no significant differences in pre-treatments of triglyceride(TG), high-density lipoprotein cholesterol(HDL-C), total cholesterol(TC), and low-density lipoprotein cholesterol(LDL-C) between the 2 groups(P>0.05). TG, TC, LDL-C, and HDL-C were better than those before treatment, and the experimental group was superior to the control group(P<0.05);the incidence of adverse reactions in the 2 groups was compared(P>0.05). Conclusion Pioglitazone can assist the treatment of T2 DM and increase the sensitivity of β cell in patients with T2 DM.