沙格列汀改善2型糖尿病患者胰岛素抵抗的临床研究

摘要

Objective To evaluate the effects of saxagliptin on insulin resistance in patients with type 2 diabetes.Methods A total of 40 patients with primary diagosed 2 diabetes were enrolled and administrated with saxagliptin (5 mg,1 time/d) for 12 weeks.The changes of fasting plasm glucose (FPG),2 h postprandial blood glucose (2 h PG),glycosylated hemoglobin (HbA1C),homeostasis model assessment β cell function index (HOMA-B),HOMA insulin resistance index (HOMA-IR) and high sensitivity C reactive protein (hs-CRP) were evaluated after 12 weeks of treatment.Results FPG,2 h PG,HbA1c,HOMA-IR,hs-CRP were significantly decreased [(9.2 ± 1.6) mmol/L,(12.7 ± 2.3) mmol/L,(8.1 ± 0.6) ％,3.8 ± 1.1,(31 ± 6) mg/L vs (7.0 ± 0.9)mmol/L,(8.1 ±1.2)mmol/L,(7.1 ±0.6)％,2.6±1.0,(12±6)mg/L,P＜0.01].HOMA-B was significantly increased (27 ± 8 vs 15 ± 6,P ＜ 0.01).Conclusion Saxagliptin can effectively improve insulin resistance in patients with type 2 diabetes,which might be due to its anti-inflammatory function.%目的 观察沙格列汀治疗对2型糖尿病患者胰岛素抵抗的影响.方法 40例初诊的2型糖尿病患者口服沙格列汀治疗12周,治疗前后检测空腹血糖、餐后2h血糖、糖化血红蛋白(HbA1c)、空腹胰岛素和高敏C反应蛋白(hs-CRP),计算稳态模型评估的胰岛素分泌指数(HOMA-B)和稳态模型评估的胰岛素抵抗指数(HOMA-IR).结果 沙格列汀治疗12周后,患者空腹血糖、餐后2h血糖、HbA1c、HOMA-IR、hs-CRP均较治疗前明显下降[(7.0±0.9)mmol/L比(9.2±1.6) mmol/L、(8.1±1.2)mmol/L比(12.7 ±2.3) mmol/L、(7.1±0.6)％比(8.1±0.6)％、2.6±1.0比3.8±1.1、(12±6)mg/L比(31±6)mg/L,均P＜0.01),HOMA-B较治疗前明显增加(27 ±8比15 ±6,P＜0.01).结论 沙格列汀能有效改善2型糖尿病患者的胰岛素抵抗状态,其抗炎作用可能是致机体胰岛素敏感性增加的原因之一.