Objective:To investigate the effect of liraglutide combined with basal insulin on blood glucose control, lipid metabolism and oxidative stress in patients with newly diagnosed type 2 diabetes mellitus complicated by o...Objective:To investigate the effect of liraglutide combined with basal insulin on blood glucose control, lipid metabolism and oxidative stress in patients with newly diagnosed type 2 diabetes mellitus complicated by obesity.Methods: A total of 58 patients with newly diagnosed type 2 diabetes mellitus complicated by obesity who were diagnosed and treated in Xi'an No. 4 Hospital between February 2017 and August 2017 were divided into the control group (n=29) who received basal insulin therapy and the liraglutide group (n=29) who received liraglutide combined with basal insulin therapy according to random number table. The differences in the levels of glycolipid metabolism indexes and the contents of oxidative stress indexes were compared between the two groups before and after treatment.Results: Before treatment, the differences in the levels of glycolipid metabolism indexes in peripheral blood and the contents of oxidative stress indexes in serum were not statistically significant between the two groups. After 1 month of treatment, glucose metabolism indexes FBG and HOMA-IR levels in peripheral blood of liraglutide group were lower than those of control group;lipid metabolism indexes TC, TG, ApoB levels in peripheral blood were lower than those of control group, ApoA1 level was higher than those of control group;serum oxidation indexes MDA and LHP contents were lower than those of control group whereas anti-oxidation indexes GSH-Px and T-AOC contents were higher than those of control group.Conclusion: Liraglutide combined with basal insulin therapy can further control the glucolipid metabolism levels and inhibit the systemic oxidative stress response in patients with newly diagnosed type 2 diabetes mellitus complicated by obesity.展开更多
AIM: To assess the effects of sitagliptin and nateglinide on lipid metabolism. METHODS: In a parallel group comparative open trial, patients with type 2 diabetes mellitus under treatment at the Japanese Red Cross Medi...AIM: To assess the effects of sitagliptin and nateglinide on lipid metabolism. METHODS: In a parallel group comparative open trial, patients with type 2 diabetes mellitus under treatment at the Japanese Red Cross Medical Center were randomly assigned to receive either sitagliptin (50 mg once daily) or nateglinide (90 mg three times daily before meals). Eligible patients met the following criteria: age ≥ 20 years; hemoglobin A 1c (HbA 1c ) > 6.5% despite diet and exercise; HbA 1c between 6.5% and 8.0%; fasting glucose < 7.77 mmol/L; diet and exercise therapy for more than 3 mo; and ability to read and understand the information for written informed consent. Exclusion criteria were contraindications to sitagliptin, contraindications to nateglinide, pregnancy or possible pregnancy, and severe liver/renal failure. Patients who were considered to be unsuitable by the attending physician for other reasons were also excluded. Blood samples were collected at one and three hours after intake of a test meal. The primary outcome measure was the area under the curve (AUC) of apolipoprotein (Apo) B48 at three hours postprandially. RESULTS: Twenty patients were randomly assigned to the sitagliptin group and sixteen patients were randomized to the nateglinide group. All 36 patients took the medication as directed by the physician in both groups, and they all were analyzed. Apart from antidiabetic drugs, there was no difference between the two groups with respect to the frequency of combined use of lipid-lowering, antihypertensive, and/or antiplatelet drugs. The doses of these medications were maintained during 12 wk of treatment. Detailed dietary advice, together with adequate exercise therapy, was given to the patients so that other factors apart from the two test drugs were similar in the two groups. There were no significant differences of the baseline characteristics between the two groups, except for body mass index (the sitagliptin group: 25.14 ± 3.05 kg/m 2 ; the nateglinide group: 21.39 ± 2.24 kg/m 2 ). Fasting levels of HbA 1c , glycated albumin, 1.5-anhydroglucitol, and blood glucose, as well as the blood glucose levels at one and three hours postprandially, improved in both groups after 12 wk of treatment, and there were no significant differences between the two groups. However, the glucagon level at one hour postprandially (P = 0.040) and the diastolic blood pressure (P<0.01) only showed a significant decrease in the sitagliptin group. In the nateglinide group, there was no significant change in the AUC of Apo B48, the glucagon level at one hour postprandially, the fasting triglyceride level, or the diastolic blood pressure. Body weight was unchanged in both groups. However, the AUC of Apo B48 at three hours postprandially showed a significant decrease in the sitagliptin group from 2.48 ± 0.11 at baseline to 1.94 ± 0.78 g/L per hour after 12 wk (P=0.019). The fasting triglyceride level also decreased significantly in the sitagliptin group (P = 0.035). With regard to lipid-related markers other than Apo B48 and fasting triglycerides, no significant changes were observed with respect to Apo A1, Apo B, or Apo C3 in either group. No adverse events occurred in either group. CONCLUSION: Sitagliptin significantly improves some lipid parameters while having a comparable effect on blood glucose to nateglinide. A large-scale prospective study of sitagliptin therapy is warranted.展开更多
目的:通过文献研究阐述中药干预肥胖型多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者代谢异常的有效性及安全性。方法:计算机检索国内外主流医药数据库中关于中医、中西医结合对比单纯西药治疗PCOS的随机对照试验(randomized con...目的:通过文献研究阐述中药干预肥胖型多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者代谢异常的有效性及安全性。方法:计算机检索国内外主流医药数据库中关于中医、中西医结合对比单纯西药治疗PCOS的随机对照试验(randomized controlled trial,RCT)。参照Cochrane系统评价手册对全文的设计方案进行质量评价,采用RevMan 5.4软件进行Meta分析。结果:纳入22项RCT进行Meta分析,中药或中西药联合治疗不仅在提升排卵率这一主要研究指标上优于单纯西药治疗(P<0.05),还在改善胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)、空腹胰岛素(fasting insulin,FINS)、体质量指数(body mass index,BMI)、三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白(low density lipoprotein,LDL)、高密度脂蛋白(high density lipoprotein,HDL)等方面优于单纯西药治疗(均P<0.05),但在调节空腹血糖(fasting blood glucose,FBG)和腰臀比(waist-to-hip ratio,WHR)方面与西药治疗差异无统计学意义(均P>0.05)。结论:中药或中西药联合干预肥胖型PCOS糖脂代谢异常,具有多途径、多靶点调控作用,无严重不良反应,优于单纯西药治疗。展开更多
目的:观察益气化聚方联合硫辛酸对2型糖尿病(T2DM)患者血糖、代谢指标及周围神经病变的影响。方法:选取2020年8月至2022年12月上海中医药大学附属岳阳中西医结合医院收治的T2DM患者120例作为研究对象,采用随机数字表法分为对照组和观察...目的:观察益气化聚方联合硫辛酸对2型糖尿病(T2DM)患者血糖、代谢指标及周围神经病变的影响。方法:选取2020年8月至2022年12月上海中医药大学附属岳阳中西医结合医院收治的T2DM患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组给予硫辛酸治疗,观察组在对照组基础上加用益气化聚方治疗。比较2组患者在治疗后的临床疗效、血糖变化、代谢相关指标、周围神经病变及治疗期间不良反应发生情况。结果:治疗后,观察组患者治疗总有效率高于对照组,且高低密度脂蛋白胆固醇(HDL-C)水平、总神经运动神经传导速度(MNCV)及感觉神经传导速度(SNCV)评分(正中神经和腓总神经)显著升高,差异有统计学意义(P<0.05),空腹血糖(FPG)、餐后2 h血糖(2 h PG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)与对照组比较显著降低(P<0.05)。观察组治疗期间出现血小板功能异常2例、脸色苍白1例,对照组治疗期间出现血小板功能异常2例、脸色苍白2例,2组治疗后不良反应发生情况差异无统计学意义。结论:采用益气化聚方联合硫辛酸治疗T2DM可更明显改善周围神经病变,降低血糖,控制血脂,且安全性良好。展开更多
文摘Objective:To investigate the effect of liraglutide combined with basal insulin on blood glucose control, lipid metabolism and oxidative stress in patients with newly diagnosed type 2 diabetes mellitus complicated by obesity.Methods: A total of 58 patients with newly diagnosed type 2 diabetes mellitus complicated by obesity who were diagnosed and treated in Xi'an No. 4 Hospital between February 2017 and August 2017 were divided into the control group (n=29) who received basal insulin therapy and the liraglutide group (n=29) who received liraglutide combined with basal insulin therapy according to random number table. The differences in the levels of glycolipid metabolism indexes and the contents of oxidative stress indexes were compared between the two groups before and after treatment.Results: Before treatment, the differences in the levels of glycolipid metabolism indexes in peripheral blood and the contents of oxidative stress indexes in serum were not statistically significant between the two groups. After 1 month of treatment, glucose metabolism indexes FBG and HOMA-IR levels in peripheral blood of liraglutide group were lower than those of control group;lipid metabolism indexes TC, TG, ApoB levels in peripheral blood were lower than those of control group, ApoA1 level was higher than those of control group;serum oxidation indexes MDA and LHP contents were lower than those of control group whereas anti-oxidation indexes GSH-Px and T-AOC contents were higher than those of control group.Conclusion: Liraglutide combined with basal insulin therapy can further control the glucolipid metabolism levels and inhibit the systemic oxidative stress response in patients with newly diagnosed type 2 diabetes mellitus complicated by obesity.
文摘AIM: To assess the effects of sitagliptin and nateglinide on lipid metabolism. METHODS: In a parallel group comparative open trial, patients with type 2 diabetes mellitus under treatment at the Japanese Red Cross Medical Center were randomly assigned to receive either sitagliptin (50 mg once daily) or nateglinide (90 mg three times daily before meals). Eligible patients met the following criteria: age ≥ 20 years; hemoglobin A 1c (HbA 1c ) > 6.5% despite diet and exercise; HbA 1c between 6.5% and 8.0%; fasting glucose < 7.77 mmol/L; diet and exercise therapy for more than 3 mo; and ability to read and understand the information for written informed consent. Exclusion criteria were contraindications to sitagliptin, contraindications to nateglinide, pregnancy or possible pregnancy, and severe liver/renal failure. Patients who were considered to be unsuitable by the attending physician for other reasons were also excluded. Blood samples were collected at one and three hours after intake of a test meal. The primary outcome measure was the area under the curve (AUC) of apolipoprotein (Apo) B48 at three hours postprandially. RESULTS: Twenty patients were randomly assigned to the sitagliptin group and sixteen patients were randomized to the nateglinide group. All 36 patients took the medication as directed by the physician in both groups, and they all were analyzed. Apart from antidiabetic drugs, there was no difference between the two groups with respect to the frequency of combined use of lipid-lowering, antihypertensive, and/or antiplatelet drugs. The doses of these medications were maintained during 12 wk of treatment. Detailed dietary advice, together with adequate exercise therapy, was given to the patients so that other factors apart from the two test drugs were similar in the two groups. There were no significant differences of the baseline characteristics between the two groups, except for body mass index (the sitagliptin group: 25.14 ± 3.05 kg/m 2 ; the nateglinide group: 21.39 ± 2.24 kg/m 2 ). Fasting levels of HbA 1c , glycated albumin, 1.5-anhydroglucitol, and blood glucose, as well as the blood glucose levels at one and three hours postprandially, improved in both groups after 12 wk of treatment, and there were no significant differences between the two groups. However, the glucagon level at one hour postprandially (P = 0.040) and the diastolic blood pressure (P<0.01) only showed a significant decrease in the sitagliptin group. In the nateglinide group, there was no significant change in the AUC of Apo B48, the glucagon level at one hour postprandially, the fasting triglyceride level, or the diastolic blood pressure. Body weight was unchanged in both groups. However, the AUC of Apo B48 at three hours postprandially showed a significant decrease in the sitagliptin group from 2.48 ± 0.11 at baseline to 1.94 ± 0.78 g/L per hour after 12 wk (P=0.019). The fasting triglyceride level also decreased significantly in the sitagliptin group (P = 0.035). With regard to lipid-related markers other than Apo B48 and fasting triglycerides, no significant changes were observed with respect to Apo A1, Apo B, or Apo C3 in either group. No adverse events occurred in either group. CONCLUSION: Sitagliptin significantly improves some lipid parameters while having a comparable effect on blood glucose to nateglinide. A large-scale prospective study of sitagliptin therapy is warranted.
文摘目的:通过文献研究阐述中药干预肥胖型多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者代谢异常的有效性及安全性。方法:计算机检索国内外主流医药数据库中关于中医、中西医结合对比单纯西药治疗PCOS的随机对照试验(randomized controlled trial,RCT)。参照Cochrane系统评价手册对全文的设计方案进行质量评价,采用RevMan 5.4软件进行Meta分析。结果:纳入22项RCT进行Meta分析,中药或中西药联合治疗不仅在提升排卵率这一主要研究指标上优于单纯西药治疗(P<0.05),还在改善胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)、空腹胰岛素(fasting insulin,FINS)、体质量指数(body mass index,BMI)、三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白(low density lipoprotein,LDL)、高密度脂蛋白(high density lipoprotein,HDL)等方面优于单纯西药治疗(均P<0.05),但在调节空腹血糖(fasting blood glucose,FBG)和腰臀比(waist-to-hip ratio,WHR)方面与西药治疗差异无统计学意义(均P>0.05)。结论:中药或中西药联合干预肥胖型PCOS糖脂代谢异常,具有多途径、多靶点调控作用,无严重不良反应,优于单纯西药治疗。
文摘目的:观察益气化聚方联合硫辛酸对2型糖尿病(T2DM)患者血糖、代谢指标及周围神经病变的影响。方法:选取2020年8月至2022年12月上海中医药大学附属岳阳中西医结合医院收治的T2DM患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组给予硫辛酸治疗,观察组在对照组基础上加用益气化聚方治疗。比较2组患者在治疗后的临床疗效、血糖变化、代谢相关指标、周围神经病变及治疗期间不良反应发生情况。结果:治疗后,观察组患者治疗总有效率高于对照组,且高低密度脂蛋白胆固醇(HDL-C)水平、总神经运动神经传导速度(MNCV)及感觉神经传导速度(SNCV)评分(正中神经和腓总神经)显著升高,差异有统计学意义(P<0.05),空腹血糖(FPG)、餐后2 h血糖(2 h PG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)与对照组比较显著降低(P<0.05)。观察组治疗期间出现血小板功能异常2例、脸色苍白1例,对照组治疗期间出现血小板功能异常2例、脸色苍白2例,2组治疗后不良反应发生情况差异无统计学意义。结论:采用益气化聚方联合硫辛酸治疗T2DM可更明显改善周围神经病变,降低血糖,控制血脂,且安全性良好。
