磷酸西格列汀对2型糖尿病患者胰岛素功能及糖脂代谢的影响研究

Effects of sitagliptin phosphate on insulin function and glucose and lipid metabolism in type 2 diabetes mellitus

目的观察磷酸西格列汀对2型糖尿病(T2DM)患者胰岛功能及糖脂代谢的影响。方法本研究为前瞻性研究,研究对象选取河南科技大学第二附属医院2022年1月至2023年12月收治的125例T2DM患者为研究对象。应用计算机随机数字表将入组患者分别列为常规组(62例)和联合组(63例),常规组予以常规药物治疗,联合组采用磷酸西格列汀联合常规药物治疗,比较两组患者的肠促胰岛素指标[胰高血糖素样肽-1(GLP-1)、葡萄糖依赖性促胰岛素多肽(GIP)]、胰岛素功能指标[空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感系数(ISI)]、糖脂代谢指标[空腹血糖(FBG)、血清瘦素(LEP)、血清脂联素(ADP)]、骨代谢指标[骨保护素(OPG)、骨特异性碱性磷酸酶(BALP)、1型胶原C端β特殊序列(β-CTX)]及糖尿病相关并发症发生情况。结果在不同治疗方案下,联合组的GPL-1、GIP均高于常规组;FINS、HOMA-IR均低于常规组,ISI高于常规组;联合组的FBG、LEP分别为(5.82±1.31)mmol/L、(4.88±1.31)ng/mL,均低于常规组(6.51±1.82)mmol/L、(5.52±1.72)ng/mL,ADP(5.36±1.29)ng/L高于常规组(4.41±1.77)ng/L;联合组的OPG、BALP分别为(2.14±0.26)ng/L、(15.47±3.36)μg/L,均高于常规组(1.48±0.65)ng/L、(12.44±3.19)μg/L,β-CTX(0.76±0.14)ng/mL低于常规组(1.33±0.78)ng/mL;联合组的糖尿病相关并发症发生率4.76%(3/63)低于常规组19.35%(12/62),差异均具有统计学意义(P<0.05)。结论磷酸西格列汀能通过改善T2DM患者的胰岛素功能而调节糖脂代谢水平及骨代谢水平,对降低相关并发症发生风险有重要意义。

Objective To observe the effect of sitagliptin phosphate on insulin function and glucose and lipid metabolism in type 2 diabetes mellitus(T2DM).Methods This was a prospective study involving 125 T2DM patients admitted to the Second Affiliated Hospital of Henan University of Science and Technology from January 2022 to December 2023.They were randomly assigned into the conventional group(62 cases)and combination group(63 cases)using computer randomization method.Conventional drugs were given to all patients,and sitagliptin phosphate was additionally given to those of the combination group.The intestinal proinsulin indicators(glucagon-like peptide-1[GLP-1]and gastric inhibitory polypeptide[GIP]),insulin function indicators(fasting insulin[FINS],Homeostatic Model Assessment for Insulin Resistance[HOMA-IR],and insulin sensitivity index[ISI]),glucose and lipid metabolism indicators(fasting glucose[FBG],leptin[LEP],and adiponectin[ADP]),bone metabolism indicators(osteoprotectin[OPG],bone alkaline phosphatase[BALP]and beta-C-terminal telopeptide[β-CTX])and T2DM-associated complications were compared between groups.Results Under different treatment regimens,patients in the combination group had significantly higher GPL-1,GIP and ISI,but lower FINS and HOMA-IR than those of conventional group(P<0.05).FBG([5.82±1.31]mmol/L VS[6.51±1.82]mmol/L)and LEP([4.88±1.31]ng/mL VS[5.52±1.72]ng/mL)in the combination group were significantly lower than those of conventional group,while ADP([5.36±1.29]ng/L VS[4.41±1.77]ng/L)was significantly higher(P<0.05).Patients in the combination group had significantly higher OPG([2.14±0.26]ng/L VS[1.48±0.65]ng/L)and BALP([15.47±3.36]μg/L VS[12.44±3.19]μg/L),and lowerβ-CTX([0.76±0.14]ng/mL VS[1.33±0.78]ng/mL)than those of conventional group(P<0.05).The incidence of T2DM-associated complications was significantly lower in the combination group than that of conventional group(4.76%[3/63]VS 19.35%[12/62],P<0.05).Conclusion Sitagliptin phosphate can improve glucose,lipid,and bone metabolism levels in T2DM patients by improving insulin function,which is of great significance in reducing the risk of related complications.