Shimabukuro Michio, Higa Namio, Takasu Nobuyuki
Second Department of Internal Medicine, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
J Diabetes Complications. 2006 May-Jun;20(3):179-83. doi: 10.1016/j.jdiacomp.2005.06.012.
The aim of the present study is to compare the short-term effects of gliclazide and glibenclamide on the oxidative state and vascular endothelium function of Type 2 diabetic patients in an observer-blinded, randomized crossover study. Thirteen Type 2 diabetic patients were enrolled: one group of seven patients took daily 160 mg of gliclazide for the first 4 weeks and then daily 5 mg of glibenclamide for the next 4 weeks; another group of six patients took daily 5 mg of glibenclamide for the first 4 weeks and 160 mg of gliclazide for the next 4 weeks. Forearm blood flow (FBF) measurement for endothelial function and biochemical analyses were conducted before and after each crossover treatment. Four weeks of treatment with either sulfonylurea showed the similar antihyperglycemic effects and enhancement of the peak FBF and total reactive hyperemic flow (flow debt repayment: FDR) during reactive hyperemia. Treatment with gliclazide resulted in the significant reduction to about 60% of baseline in urinary 8-iso-prostaglandin F2alpha (8iPGF2alpha) excretion while no such change was detected in the glibenclamide period. The increases in peak FBF and FDR were in parallel with its anti-hyperglycemic effect, but not with antioxidant state. Results suggest that gliclazide and glibenclamide can protect vascular endothelium from hyperglycemia-induced injury in Type 2 diabetic patients.
本研究旨在通过一项观察者盲法随机交叉研究，比较格列齐特和格列本脲对2型糖尿病患者氧化状态和血管内皮功能的短期影响。招募了13名2型糖尿病患者：一组7名患者在最初4周每天服用160毫克格列齐特，然后在接下来4周每天服用5毫克格列本脲；另一组6名患者在最初4周每天服用5毫克格列本脲，在接下来4周每天服用160毫克格列齐特。在每次交叉治疗前后进行内皮功能的前臂血流量（FBF）测量和生化分析。两种磺脲类药物治疗4周均显示出相似的降糖效果，并增强了反应性充血期间的峰值FBF和总反应性充血流量（流量偿还：FDR）。格列齐特治疗导致尿8-异前列腺素F2α（8iPGF2α）排泄量显著降低至基线的约60%，而在格列本脲治疗期间未检测到此类变化。峰值FBF和FDR的增加与其降糖作用平行，但与抗氧化状态无关。结果表明，格列齐特和格列本脲可保护2型糖尿病患者的血管内皮免受高血糖诱导的损伤。
