Department of Endocrinology, Union Hospital, Huazhong University of Science and Technology, Wuhan, China.
Endocrine. 2010 Oct;38(2):266-75. doi: 10.1007/s12020-010-9383-8. Epub 2010 Oct 23.
Circulating endothelial progenitor cells (EPCs) play an important role in the development and progression of diabetic vascular complications. The aim of this study was to investigate the effects of gliclazide plus metformin (GLIMET) compared with metformin alone (MET) on number and function of circulating EPCs in T2DM patients. Patients with newly diagnosed T2DM were randomly divided into two groups, receiving the following treatments for 16 weeks: MET group (assuming metformin 500-2500 mg/day, n=24) and GLIMET group [assuming gliclazide (modified release, 30-60 mg/day)+metformin (250-1000 mg/day), n=23]. Circulating EPCs were quantified by flow cytometry, and the ability to uptake LDL and stain for lectin were used as another method of characterizing EPCs ex vivo. The functions of circulating EPCs were evaluated by colony-forming units (CFU) and migration. The status of oxidative stress was analyzed by serum-free malonaldehyde (MDA) and superoxide dismutase (SOD). There were no significant differences in clinical characteristics and number and function of circulating EPCs between two groups at baseline. Glycemic responses were similar after treatments. Compared with MET group, GLIMET group was associated with an increase in circulating EPCs number, DiLDL-lectin-positive EPCs, and migration. The mean improvements in MDA and SOD of GLIMET group were more strongly upregulated than those of MET group. This study demonstrated that both metformin mono-treatment and metformin plus gliclazide combination treatment provided with improvements in number and function of circulating EPCs. Compared with metformin mono-treatment, early use of combination therapy with gliclazide plus metformin made more effective improvements in circulating EPCs.
循环内皮祖细胞 (EPCs) 在糖尿病血管并发症的发生和发展中起着重要作用。本研究旨在探讨格列齐特联合二甲双胍 (GLIMET) 与单独使用二甲双胍 (MET) 对 2 型糖尿病患者循环 EPC 数量和功能的影响。新诊断为 2 型糖尿病的患者被随机分为两组，分别接受以下治疗 16 周：MET 组（假设二甲双胍 500-2500mg/天，n=24）和 GLIMET 组[假设格列齐特（缓释，30-60mg/天）+二甲双胍（250-1000mg/天），n=23]。通过流式细胞术定量循环 EPC，使用摄取 LDL 和凝集素染色的能力作为体外鉴定 EPC 的另一种方法。通过集落形成单位 (CFU) 和迁移评估循环 EPC 的功能。通过无血清丙二醛 (MDA) 和超氧化物歧化酶 (SOD) 分析氧化应激状态。两组患者在基线时的临床特征、循环 EPC 数量和功能均无显著差异。治疗后血糖反应相似。与 MET 组相比，GLIMET 组循环 EPC 数量、DiLDL-凝集素阳性 EPC 及迁移增加。GLIMET 组 MDA 和 SOD 的平均改善程度比 MET 组更强上调。本研究表明，二甲双胍单药治疗和二甲双胍加格列齐特联合治疗均可改善循环 EPC 的数量和功能。与二甲双胍单药治疗相比，早期使用格列齐特联合二甲双胍联合治疗可更有效地改善循环 EPC。
