阿格列汀对经二甲双胍治疗的肥胖2型糖尿病患者外周血氧化相关物质活性的影响

摘要

Objective To observe the effect of alogliptin on content of oxidative related substances in obese type 2 diabetes patients treated by metformin and evaluate its efficacy and safety .Methods Obese patients (200 ca‐ses) with type 2 diabetes were randomly divided into observation and control groups(n = 100) .The patients in the control group were given metformin (1 000 mg ,bid po) .The patients in the observation group were given metformin (500 mg ,bid po) and alogliptin(25 mg ,twice po) .The patients in the two groups were treated for 24 weeks .We ob‐served the changes of the oxydic and antioxidative index and body mass index (BMI) ,waist circumference(W) ,glyco‐sylated hemoglobinA1c(HbA1c) ,fasting plasma glucose (FBG) and 2 hour postprandial blood glucose(2 hPBG) .Re‐sults After treatment ,the ROS ,MDA ,FBG ,2 hPBG ,HbA1c ,BMI and waist circumference were reduced and all of them have statistical difference in the two groups(P< 0 .05) and they were lower in the observation group than con‐trol group(P< 0 .05) ;The activity of SOD and GSH‐PX were eascalated after treatment in the two groups(P< 0 .05) and the avtivity of SOD and GSH‐PX were higher in the observation group(P< 0 .05) .Conclusion Alogliptin com‐bined with metformin in treatment of type 2 diabetes with obesity can effectively improve the imbalance of the oxida‐tive related substances in the serum and can reduce the BMI ,waist circumference ,and does not increase the risk of hypoglycemia ,which was worthy of clinical popularization and application .%目的：探讨阿格列汀对经二甲双胍治疗的肥胖2型糖尿病患者外周血清氧化相关物质活性的影响，并评估该方案的有效性与安全性。方法选取肥胖的2型糖尿病患者200例（均为二甲双胍单药控制不佳），随机分为观察组（100例）和对照组（100例）。对照组患者采用二甲双胍（1000 mg bid ，po）治疗，观察组使用二甲双胍（500 mg bid ，po）联合阿格列汀（25 mg qd ，po）治疗。2组患者规范治疗24周，比较2组治疗前后外周血超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH‐Px）、活性氧类物质（ROS）活性以及丙二醛（MDA ）浓度、体质量指数（BMI）、腰围、糖化血红蛋白（HbA1c）、空腹血糖（FBG）、餐后2 h 血糖（2 hPBG）的变化情况。结果治疗后，2组患者 ROS 、MDA 、FBG 、2 hPBG 、HbA1c 、BMI 、腰围均较治疗前降低，差异有统计学意义（P＜0．05）。治疗后观察组患者各指标明显低于对照组，差异有统计学意义（P＜0．05）；2组治疗后 SOD 、GSH‐Px 活性较治疗前升高，差异有统计学意义（P＜0．05），治疗后观察组患者各指标明显高于对照组，差异有统计学意义（P＜0．05）。结论阿格列汀联合二甲双胍可有效纠正肥胖2型糖尿病患者的外周血氧化与抗氧化物质的失衡，同时能降低患者 BMI 、腰围等指标，且不增加低血糖风险，具有临床价值。