[目的]探讨二肽基肽酶4抑制剂(DPP-4i)对2型糖尿病(T2DM)患者血清肌酐(Cr)的影响。[方法]系统检索PubMed、Embase、Cochrane Library和Web of Science数据库,纳入DPP-4i治疗T2DM患者调节Cr的随机对照试验(RCT)。采用固定效应或随机效应...[目的]探讨二肽基肽酶4抑制剂(DPP-4i)对2型糖尿病(T2DM)患者血清肌酐(Cr)的影响。[方法]系统检索PubMed、Embase、Cochrane Library和Web of Science数据库,纳入DPP-4i治疗T2DM患者调节Cr的随机对照试验(RCT)。采用固定效应或随机效应模型进行数据拟合,采用I^(2)指数定量评价异质性,使用标准方法进行敏感性分析和发表偏倚检验。[结果]经系统检索数据库,纳入12项RCT,共计2276名受试者。由于潜在异质性的原因,故采用随机效应模型进行数据拟合,DPP-4i治疗可轻度提高T2DM患者的Cr水平(WMD:0.15 mg/L,95%CI:0.03~0.27,I^(2)=18%,P=0.02),结果具有统计学差异。根据敏感性测试,Meta分析其结果较为可靠。同时进行Begg’s与Egger’s检验,未见发表偏倚。[结论]T2DM患者应用DPP-4i进行降糖治疗,可能会出现血Cr水平轻度升高。未来还需开展更大样本量的多中心研究,以进一步探讨DPP-4i治疗引起Cr水平改变的临床意义。展开更多
Nuciferine contained in lotus leaves have been confirmed to have the effect of ameliorating hyperlipemia and hyperglycemia.A laser scanning confocal microscope was used to track the translocation of glucose transporte...Nuciferine contained in lotus leaves have been confirmed to have the effect of ameliorating hyperlipemia and hyperglycemia.A laser scanning confocal microscope was used to track the translocation of glucose transporter 4(GLUT4)in L6 cells and the changes in intracellular Ca^(2+)levels in real time,and related protease inhibitors combined with western blotting were used to explore the mechanism of nuciferine.Meanwhile,KK-Ay mice,the spontaneous type 2 diabetic mice,were used to evaluate the in vivo activity of nuciferine.In this study,the in vitro studies indicated that nuciferine-induced GLUT4 translocation was regulated by G protein-PLC-PKC and AMPK pathways and nuciferine-enhanced intracellular Ca^(2+)was mediated by G protein-PLC-IP3-IP3R pathway,the increase in intracellular Ca^(2+)caused by nuciferine was not directly related to GLUT4 translocation,but both promote glucose uptake.The in vivo results suggested that nuciferine ameliorated weight gain induced by high-fat diet,abnormal lipid metabolism and the symptoms of insulin resistance in KK-Ay diabetic mice.Western blot results suggested that nuciferine increased AMPK and PKC phosphorylation levels in skeletal muscle and liver,and enhanced GLUT4 expression in skeletal muscle.Taken together,this research showed that nuciferine has the non-negligible potential in the treatment of type 2 diabetes mellitus.展开更多
文摘[目的]探讨二肽基肽酶4抑制剂(DPP-4i)对2型糖尿病(T2DM)患者血清肌酐(Cr)的影响。[方法]系统检索PubMed、Embase、Cochrane Library和Web of Science数据库,纳入DPP-4i治疗T2DM患者调节Cr的随机对照试验(RCT)。采用固定效应或随机效应模型进行数据拟合,采用I^(2)指数定量评价异质性,使用标准方法进行敏感性分析和发表偏倚检验。[结果]经系统检索数据库,纳入12项RCT,共计2276名受试者。由于潜在异质性的原因,故采用随机效应模型进行数据拟合,DPP-4i治疗可轻度提高T2DM患者的Cr水平(WMD:0.15 mg/L,95%CI:0.03~0.27,I^(2)=18%,P=0.02),结果具有统计学差异。根据敏感性测试,Meta分析其结果较为可靠。同时进行Begg’s与Egger’s检验,未见发表偏倚。[结论]T2DM患者应用DPP-4i进行降糖治疗,可能会出现血Cr水平轻度升高。未来还需开展更大样本量的多中心研究,以进一步探讨DPP-4i治疗引起Cr水平改变的临床意义。
基金financially supported by National Natural Science Foundation of China grants(81573561,81911540487,31070744)the Fundamental Research Funds for the Central Universities,South-Central University for Nationalities(CZR18003).
文摘Nuciferine contained in lotus leaves have been confirmed to have the effect of ameliorating hyperlipemia and hyperglycemia.A laser scanning confocal microscope was used to track the translocation of glucose transporter 4(GLUT4)in L6 cells and the changes in intracellular Ca^(2+)levels in real time,and related protease inhibitors combined with western blotting were used to explore the mechanism of nuciferine.Meanwhile,KK-Ay mice,the spontaneous type 2 diabetic mice,were used to evaluate the in vivo activity of nuciferine.In this study,the in vitro studies indicated that nuciferine-induced GLUT4 translocation was regulated by G protein-PLC-PKC and AMPK pathways and nuciferine-enhanced intracellular Ca^(2+)was mediated by G protein-PLC-IP3-IP3R pathway,the increase in intracellular Ca^(2+)caused by nuciferine was not directly related to GLUT4 translocation,but both promote glucose uptake.The in vivo results suggested that nuciferine ameliorated weight gain induced by high-fat diet,abnormal lipid metabolism and the symptoms of insulin resistance in KK-Ay diabetic mice.Western blot results suggested that nuciferine increased AMPK and PKC phosphorylation levels in skeletal muscle and liver,and enhanced GLUT4 expression in skeletal muscle.Taken together,this research showed that nuciferine has the non-negligible potential in the treatment of type 2 diabetes mellitus.
