达格列净对2型糖尿病患者血糖及肝组织GSH-Px、CAT、SOD活性的影响

Effects of dapagliflozin on glucose control in patients with type 2 diabetes mellitus and its effect on GSH-Px,CAT,and SOD activities in liver tissue

目的探讨达格列净对2型糖尿病患者血糖及肝组织谷胱甘肽过氧化物酶(GSH-Px)、过氧化氢酶(CAT)、超氧化物歧化酶(SOD)活性的影响。方法84例2型糖尿病患者均分为观察组和对照组,观察组予以达格列净片进行降糖治疗,对照组予以盐酸二甲双胍片联合瑞格列奈片常规治疗,均治疗3个月;比较2组患者治疗前和治疗后空腹血糖(FPG)、餐后2 h血糖值(2 hPG)、糖化血红蛋白(HbA1c)、SOD、GSH-PX、CAT、尿α1-微球蛋白水平(α1-MG)、β2微球蛋白(β2-MG)、尿微量白蛋白(mALB)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、转铁蛋白(TRF)、免疫球蛋白(IgG)及尿白蛋白/肌酐的比值(ACR);治疗后3个月时,比较2组患者不良反应发生率。结果治疗3个月,观察组患者FPG、2 hPG、HbA1c均低于对照组,肝组织GSH-Px、CAT、SOD活性均高于对照组,差异均有统计学意义(P<0.05);治疗后观察组患者尿α1-MG、尿β2-MG、尿NAG水平低于对照组,差异均有统计学意义(P<0.05);观察组患者不良反应发生率低于对照组(P<0.05)。结论达格列净能有效控制2型糖尿病患者血糖水平,改善其肝组织GSH-Px、CAT、SOD活性。

Objective To investigate the effects of dapagliflozin on type 2 diabetes mellitus and its effects on the activities of glutathione peroxidase(GSH-Px),catalase(CAT),and superoxide dismutase(SOD)in liver tissue.Methods Eighty-four patients with type 2 diabetes were selected and divided into observation group and control group according to random number table method.The control group was given metformin hydrochloride tablets combined with repaglinide tablets for routine treatment,and the observation group was given dapagliflozin tablets for hypoglycemic treatment.The treatment period of both groups was 3 months.Before treatment and 3 months after treatment,fasting blood glucose,2 h postprandial blood glucose and HBA1c were compared between the two groups.Automatic biochemical analyzer was used to determine the blood glucose level and high performance liquid chromatograph was used to determine the HBA1c level.SOD enzyme,GSH-PX enzyme,and CAT enzyme in red blood cells of two groups were determined.The number of hypoglycemia,diarrhea,nausea,vomiting and urinary tract infection in both groups were counted,and the incidence of adverse reactions was calculated.Urinaryα1-microglobulin level(α1-MG),urinaryβ2-microglobulin(β2-MG),urinary microalbumin(mALB),urinary n-acetyl-β-D-glucosaminase(NAG),urinary transferrin(TRF),and other renal injury indexes were detected by immunochromatic-turbidimetry.Urinary immunoglobulin(IgG)was detected by radioimmunoassay,and urinary albumin and creatinine(Scr)were detected by an automatic biochemical analyzer to calculate the urinary albumin/creatinine ratio(ACR).Results At 3 months after treatment,fasting blood glucose,2 h postprandial blood glucose and HBA1c values in observation group were lower than those in control group(P<0.05),and observation group were lower than control group,with statistical significance(P<0.05).GSH-Px,CAT,and SOD activities in liver tissue of observation group were higher than those in control group,the differences were statistically significant(P<0.05),and the values were close to normal values.Activity of GSH-Px,CAT,and SOD after treatment in both groups was higher than that before treatment(P<0.05).The incidence of adverse reactions in observation group was lower than that in control group(P<0.05).After treatment,urinaryα1-MG,urinaryβ2-MG,and urinary NAG levels in the observation group were significantly lower than those in the control group,differences were statistically significant(P<0.05).Conclusion The application of dapagliflozin in the treatment of type 2 diabetes can control blood glucose and improve the activities of GSH-Px,CAT,and SOD in liver tissue well.