摘要
目的研究罗格列酮及瑞格列奈单药治疗对新诊断2型糖尿病患者急性相胰岛素分泌功能(AIR)的影响。方法筛选2001—2004年上海10家市级医院内分泌代谢科206例新诊断的2型糖尿病患者,年龄30～70岁。根据精氨酸刺激试验分为AIR正常组及AIR低下组,再进一步随机进入罗格列酮单药治疗亚组与瑞格列奈单药治疗亚组,每12周随访一次,总观察期限为48周。结果治疗后各亚组的血糖(PG)、糖化血红蛋白(HbA1c)均较基线时明显降低(P<0.05)。157例完成随访者研究结束时HbA1c达标率(<6.5%)为63.0%。AIR正常组中,罗格列酮亚组的胰岛素原(PI)、PI/真胰岛素(TI)降低(P<0.01),瑞格列奈亚组的TI显著增高(P<0.05)。AIR低下组中,罗格列酮亚组的PI、PI/TI及胰岛素抵抗指数(HOMA-IR)明显降低(P<0.05),而精氨酸刺激的ΔTI/PG及其曲线下面积(AUC)明显增加(P<0.01)。瑞格列奈亚组TI及AUC升高(P<0.01),但PI/TI下降(P<0.05)。结论罗格列酮能改善2型糖尿病患者的AIR。
Objective The study was to evaluate the effect of rosiglitazone and repaglinide on acute insulin response group （AIR） in patients with newly diagnosed type 2 diabetes. Methods At baseline,206 newly diag- nosed type 2 diabetic patients aged from 30 to 70 years were enrolled from the outpatient department of 10 hospi- tals in Shanghai. According to arginc stimulation test all subjects were divided into 2 groups as follows ： normal AIR and impaired AIR group, each group was divided into 2 subgroups, treated with rosiglitazone and repaglinide ran- domly. Study subjects were followed up for 48 weeks. Results Plasma glucose （PG） and hemoglobin Alc （ HbA1 c） in all subgroups were significantly decreased alter treatment （ P 〈 0. 05 ）. The proportion of 157 patients reaching the HbAlc targets （ 〈6. 5% ） was 63.0% at the end of study. In normal AIR group,proinsulin （PI） and proinsulin/true insulin （TI） decreased significantly in rosiglitazone subgroup （P 〈 0. 01 ） and TI increased in repaglinide subgroup （ P 〈 0. 05 ）. In impaired AIR group, PI, PI/TI and homeostasis model assessment of insu- lin resistance （HOMA-IR） significantly decreased in rosiglitazone subgroup （ P 〈 0. 05 ） , while plasma glucose adjusted AIR to arginine （ATI/PG） and arginine-stimulated area under the curve for insulin （AUC） increased （P 〈 0. 01 ）. Repaglinide subgroup showed an increase in TI and arginine-stimulated AUC （P 〈 0. 01 ） meanwhile a decrease in PI/TI （P 〈 0. 05 ）. Conclusion Rosglitazone could improve acute/first phase insulin response.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2010年第9期823-826,共4页
Chinese Journal of Practical Internal Medicine
基金
上海市医学发展基金重点研究课题资助项目(01ZD002[1])
上海市重点实验室项目(08DZ2230200)
关键词
2型糖尿病
罗格列酮
瑞格列奈
diabetes mellitus, type 2
rosiglitazone
repaglinide
