Yang Zhifang, Zhou Zhiguang, Li Xia, Huang Gan, Lin Jian
Diabetes Center, Institute of Metabolism and Endocrinology, Second Xiangya Hospital, Central South University, Changsha, China.
Diabetes Res Clin Pract. 2009 Jan;83(1):54-60. doi: 10.1016/j.diabres.2008.09.044. Epub 2008 Nov 12.
The newly developed insulin sensitizer-thiazolidinediones have the potential to downregulate inflammation and autoimmune response. The objective of this study was to observe the beneficial effects on beta-cell function in the LADA patients treated with rosiglitazone. 54 LADA patients were assigned to oral hypoglycemic agents group (GAD-Ab<175 U/mL and FCP>0.3 nmol/L) or early insulin administration group (GAD-Ab>or=175 U/mL or GAD-Ab<175 U/mL and FCP<or=0.3 nmol/L). Then, those patients were randomly assigned to receive sulfonylureas (SUs group) or rosiglitazone (RSG group) therapy, or to receive insulin alone (INS group) or rosiglitazone plus insulin (INS+RSG group). Plasma glucose, HbA1c, fasting C-peptide (FCP) and C-peptide after 2h 75-g glucose load (PCP) were determined every 6 months. The levels of PCP and delta CP were higher in RSG group compared with those in SUs group after the 18th month. The PCP level (after the 12th month) and delta CP level (after the 18th month) in INS+/-RSG group were higher than those in INS group. Rosiglitazone combined with insulin wherever or not preserved beta-cell function in LADA patients after 3 years.
新开发的胰岛素增敏剂——噻唑烷二酮类药物有下调炎症和自身免疫反应的潜力。本研究的目的是观察罗格列酮治疗成人隐匿性自身免疫性糖尿病（LADA）患者时对β细胞功能的有益作用。54例LADA患者被分为口服降糖药组（谷氨酸脱羧酶抗体[GAD-Ab]<175 U/mL且空腹C肽[FCP]>0.3 nmol/L）或早期胰岛素治疗组（GAD-Ab≥175 U/mL或GAD-Ab<175 U/mL且FCP≤0.3 nmol/L）。然后，将这些患者随机分为接受磺脲类药物治疗（磺脲类药物组）或罗格列酮治疗（罗格列酮组），或单独接受胰岛素治疗（胰岛素组）或罗格列酮联合胰岛素治疗（胰岛素+罗格列酮组）。每6个月测定一次血浆葡萄糖、糖化血红蛋白（HbA1c）、空腹C肽（FCP）以及75g葡萄糖负荷后2小时的C肽（PCP）。第18个月后，罗格列酮组的PCP和ΔCP水平高于磺脲类药物组。胰岛素+/-罗格列酮组第12个月后的PCP水平和第18个月后的ΔCP水平高于胰岛素组。3年后，无论是否联合胰岛素，罗格列酮在LADA患者中均能保留β细胞功能。
