非布司他治疗2型糖尿病伴高尿酸血症患者对胰岛素抵抗及γ-GGT、TyG表达的影响

Effects of febuxostat in the treatment of type 2 diabetes with hyperuricemia on insulin resistance and the expression of γ-GGT and TyG

目的 分析2型糖尿病伴高尿酸血症患者在服用非布司他进行治疗后,对其胰岛素抵抗及γ-GGT、TyG表达的影响。方法 采用随机、双盲实验设计方法选取100例蚌埠市第一人民医院接受2型糖尿病伴高尿酸血症治疗的患者,并将100例患者随机分为对照组50例,观察组50例。对照组在常规治疗的基础上给予相关药物和胰岛素治疗,观察组在对照组的基础上加用非布司他进行治疗。采用全自动生化分析仪检测γ-谷氨酸转移酶(γ-GGT)水平。三酰甘油-葡萄糖(TyG)指数计算公式为:[TyG指数=(TG×FBG)/2],这一公式来体现潜在对胰岛素抵抗现象。对比两组治疗效果。结果 治疗后,与对照组(BUN、Scr、FBG、BUA、CRP、FINS、TC、TG、LDL-C、HOMA-IR、γ-GGT、TyG)相比,观察组水平降低,差异有统计学意义(t=25.754,22.722,5.331,9.459,10.487,12.662,21.894,31.682,18.154,16.953,5.081,9.079,P<0.001)。治疗后,与对照组(eGFR、HDL-C)相比,观察组水平升高,差异有统计学意义(t=3.707,20.591,P<0.001)。观察组总有效率高于对照组,差异有统计学意义(χ^(2)=0.706,P<0.001)。结论对观察组患者采用非布司他进行治疗,能够有效恢复患者肾功能、降低空腹血糖、改善γ-GGT、TyG水平和胰岛素抵抗情况,整体疗效显著。

Objective To analyze the effects of febuxostat on insulin resistance and the expression of γ-GGT and TyG in patients with type 2 diabetes mellitus with hyperuricemia. Methods A randomized,double-blind experimental design method was used to select 100 patients with type 2 diabetes mellitus with hyperuricemia in the First People’s Hospital of Bengbu City,and divide the 100 patients into the control group with 50 cases and the observation group with 50 cases by random number table method. The control group was given related drugs and insulin on the basis of conventional treatment,and the observation group was given febuxostat on the basis of the control group. The level of γ-glutamate transferase(γ-GGT)was detected by an automatic biochemical analyzer. The formula for calculating the triacylglycerol-glucose(TyG)index is:[TyG index =(TG×FBG)/2],which reflects the potential for insulin resistance. The treatment effects of the two groups were compared. Results After treatment,compared with the control group(BUN,Scr,FBG,BUA,CRP,FINS,TC,TG,LDL-C,HOMA-IR,γ-GGTU/L,TyG),the levels in the observation group decreased,the difference was statistically significant(t=25.754,22.722,5.331,9.459,10.487,12.662,21.894,31.682,18.154,16.953,5.081,9.079,P<0.001). After treatment,compared with the control group(eGFR,HDL-C),the levels in the observation group increased,and the difference was statistically significant(t=3.707,20.591,P<0.001). The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(χ^(2)=0.706,P<0.001). Conclusion The patients in the observation group were treated with febuxostat,which could effectively restore the renal function,reduce the fasting blood glucose,improve the levels of γ-GGT,TyG and insulin resistance,and the overall curative effect was significant.