格列美脲联合二甲双胍对初诊2型糖尿病患者糖脂代谢、胰岛功能及血清miR-126表达的影响
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篇名: 格列美脲联合二甲双胍对初诊2型糖尿病患者糖脂代谢、胰岛功能及血清miR-126表达的影响
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摘要: 目的:探讨格列美脲联合二甲双胍对初诊2型糖尿病患者糖脂代谢、胰岛功能及血清微核糖核酸-126(miR-126)表达的影响。方法:选择2014年1月-2017年1月重庆市南川宏仁医院收治的初诊2 型糖尿病患者100例,按随机数字表法分为对照组和观察组,各50例。对照组患者给予盐酸二甲双胍缓释片(Ⅱ)起始剂量0.5 g,每日1次,连用12周后调整为0.5 g,每日2次,最大日剂量不超过1 g,进餐时或餐后服用;观察组患者在对照组治疗的基础上给予格列美脲片2 mg,每日1次,早餐时服用。两组患者均连续治疗至少24周。观察两组患者治疗前后血糖(空腹血糖、餐后2 h血糖、糖化血红蛋白)、血脂(总胆固醇、三酰甘油)、胰岛功能[空腹胰岛素(FINS)、餐后2 h胰岛素(2 hINS)、空腹C肽(FCP)、餐后2 hC肽(2 hCP)、胰岛素抵抗指数(HOMA-IR)]、血清miR-126表达水平及不良反应发生情况。结果:治疗前,两组患者血糖、血脂、胰岛功能、血清miR-126表达水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者血糖、血脂水平、HOMA-IR均显著低于同组治疗前,且观察组血糖水平、HOMA-IR均显著低于对照组;两组患者FINS、2 h INS、FCP、2 hCP、血清miR-126表达水平均显著高于同组治疗前,且观察组显著高于对照组,差异均有统计学意义(P<0.05)。两组患者治疗期间均未见明显不良反应发生。结论:格列美脲联合二甲双胍可显著改善初诊2 型糖尿病患者的糖脂代谢和胰岛功能,调节血清miR-126表达水平,且未增加不良反应的发生。
ABSTRACT: OBJECTIVE: To investigate the effects of glimepiride combined with metformin on glucose and lipid metabolism, islet function and serum miR-126 expression of newly diagnosed type 2 diabetes patients. METHODS: A total of 100 patients with newly diagnosed type 2 diabetes in Nanchuan Hongren Hospital of Chongqing during Jan. 2014-Jan. 2017 were divided into observation group and control group according to random numble table, with 50 cases in each group. Control group was given Metformin hydrochloride sustained-release tablets (Ⅱ) with initial dose of 0.5 g, once a day, adjusted to 0.5 g 12 weeks later, twice a day, maximal dose of 1 g at meal or after meal. Observation group was additionally given Glimepiride tablets 2 mg, once a day, at breakfast, on the basis of control group. Both group were treated at lasted for 24 weeks. The levels of blood glucose (FPG, 2 hPG, HbA1c), blood lipid (TC, TG), islet function (FINS, 2 hINS, FCP, 2 hCP, HOMA-IR), serum miR-126 before and after treatment and the occurrence of ADR were observed in 2 groups. RESULTS: Before treatment, there was no statistical significance in the levels of blood glucose, blood lipid, islet function or serum miR-126 expression between 2 groups (P>0.05). After treatment, the levels of blood glucose, blood lipid and HOMA-IR in 2 groups were significantly lower than before treatment, and the levels of blood glucose and HOMA-IR in observation group were significantly lower than control group. The levels of FINS, 2 hINS, FCP and 2 hCP, serum miR-126 expression in 2 groups were significantly higher than before treatment, and the observation group was significantly higher than control group, with statistical significance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS: Glimepiride combined with metformin can significantly improve glucose and lipid metabolism, islet function, and regulate serum miR-126 expression without increasing the occurrence of ADR.
期刊: 2018年第29卷第4期
作者: 谈晓娅,童强
AUTHORS: TAN Xiaoya,TONG Qiang
关键字: 格列美脲;二甲双胍; 2型糖尿病;血糖;血脂;胰岛功能;微核糖核酸-126
KEYWORDS: Glimepiride; Metformin; Type 2 diabetes; Blood glucose; Blood lipid; Islet function; miR-126
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