钠-葡萄糖共同转运体2抑制剂对2型糖尿病患者胰岛素敏感性及血清GPC-4的影响

Effects of sodium-glucose co-transporter 2 inhibitor on insulin sensitivity and serum GPC-4 in patients with type 2 diabetes mellitus

目的 :探讨达格列净对2型糖尿病(type 2 diabetes mellitus,T2DM)患者胰岛素敏感性及血清磷脂酰肌醇蛋白聚糖-4(glypican-4,GPC-4)的影响。方法:80例T2DM患者采用达格列净治疗12周,观察血糖、血脂、胰岛素敏感性及血清GPC-4水平的变化。以40例健康人作为正常对照。结果:T2DM组(5.05±0.98)的血清GPC-4水平低于正常对照组(6.42±0.51)(P=0.000),T2DM组经达格列净治疗后血糖(P=0.000)、HbA1c(P=0.000)和HOMA-IR(P=0.000)均降低,而GPC-4水平升高(P=0.000)。在T2DM组,HbA1c(β=-0.608,P=0.000)和1/HOMA-IR(β=-2.566,P=0.003)均是血清GPC-4的独立影响因子,但治疗前后GPC-4的升高程度与HbA1c降低程度正相关(r=0.397,P=0.002),与HOMA-IR的变化无关(r=-0.062,P=0.539)。结论:达格列净具有降糖、改善胰岛素敏感性和升高循环GPC-4水平的作用,但其对血清GPC-4的影响可能与降糖有关,与其改善胰岛素敏感性的作用无关。

Objective:To investigate the effects of dapagliflozin on insulin sensitivity and serum glypican-4(GPC-4) levels in patients with type 2 diabetes mellitus(T2DM). Methods:Eighty patients with T2DM were treated with dapagliflozin for 12 weeks,and the changes of blood glucose,blood lipid,insulin sensitivity and serum GPC-4 level were observed by an ELISA kit. Forty healthy subjects were taken as normal glucose control(NGT). Results:Serum GPC-4 levels were lower in T2DM(5.05±0.98) group than in NGT group(6.42 ±0.51)(P=0.000). Dapagliflozin increased serum GPC-4 levels in T2DM group(P =0.000),accompanied with decreases in blood glucose levels(P=0.000),HbA1 c(P=0.000) and HOMA-IR(P=0.000). HbA1c(β=-0.608,P=0.000) and 1/HOMAIR(β=-2.566,P=0.003) were independent influencing factors of serum GPC-4 in T2DM patients. Elevation in serum GPC-4 levels were correlated positively with reduces in HbA1c(r=0.397,P=0.002),but no associations with decline in HOMA-IR(r=-0.062,P=0.539). Conclusion:Dapagliflozin therapy can decrease blood glucose levels,improve insulin sensitivity and increase GPC-4 levels for T2DM patients,and its effects on the serum GPC-4 level may be correlated with glucose control,but have no association with insulin sensitivity improvement.