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6个月西他列汀治疗对2型糖尿病患者糖脂代谢、血压、体重及肾功能的影响:一项基于图表的分析

Effects of 6-month sitagliptin treatment on glucose and lipid metabolism, blood pressure, body weight and renal function in type 2 diabetic patients: a chart-based analysis.

作者信息

Yanai Hidekatsu, Adachi Hiroki, Hamasaki Hidetaka, Masui Yoshinori, Yoshikawa Reo, Moriyama Sumie, Mishima Shuichi, Sako Akahito

机构信息

Department of Internal Medicine, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba 272-8516, Japan.

出版信息

J Clin Med Res. 2012 Aug;4(4):251-8. doi: 10.4021/jocmr975w. Epub 2012 Jul 20.

Abstract

BACKGROUND

Sitagliptin is one of the dipeptidyl peptidase-4 (DPP-4) inhibitors which prevent the inactivation of incretins, increasing the endogenous active incretin levels. Incretins stimulate insulin secretion from pancreatic β-cells and inhibit glucagon secretion from pancreatic α-cells, which is favorable for the treatment of diabetes. Sitagliptin is released on December, 2009, in Japan. We retrospectively studied effects of 6-month-treatment with sitagliptin on glucose and lipid metabolism, blood pressure, body weight and renal function in patients with type 2 diabetes by a chart-based analysis.

METHODS

We retrospectively studied 220 type 2 diabetic patients who have taken sitagliptin for 6 months by a chart-based analysis. Subjects studied include patients treated with sitagliptin monotherapy, sitagliptin add-on therapy, and switching from glinide to sitagliptin. We selected patients who have both data before and after 6-month sitagliptin treatment and compared the data before the sitagliptin treatment with the data at 6 month after the sitagliptin treatment started. Body weight, blood pressure, plasma glucose, hemoglobin A1c (HbA1c), serum lipids, and estimated glomerular filtration rate in type 2 diabetic patients were measured almost at the same time points before and after 6-month-treatment with sitagliptin.

RESULTS

Body weight was significantly reduced after 6-month sitagliptin treatment by 0.8 kg. HbA1c levels were also significantly decreased after the sitagliptin treatment by 0.6%. We found a significant and negative correlation between change in body weight and body mass index at baseline. We also observed a significant and negative correlation between change in HbA1c and HbA1c levels at baseline. The number of patients who showed the absence of urinary glucose was significantly increased after the sitagliptin treatment.

摘要

背景

西他列汀是二肽基肽酶-4(DPP-4)抑制剂之一,可防止肠促胰岛素失活,提高内源性活性肠促胰岛素水平。肠促胰岛素刺激胰腺β细胞分泌胰岛素,并抑制胰腺α细胞分泌胰高血糖素,这有利于糖尿病的治疗。西他列汀于2009年12月在日本上市。我们通过基于图表的分析,回顾性研究了西他列汀治疗6个月对2型糖尿病患者糖脂代谢、血压、体重和肾功能的影响。

方法

我们通过基于图表的分析,回顾性研究了220例服用西他列汀6个月的2型糖尿病患者。研究对象包括接受西他列汀单药治疗、西他列汀联合治疗以及从格列奈类药物转换为西他列汀治疗的患者。我们选择了在西他列汀治疗6个月前后均有数据的患者,并将西他列汀治疗前的数据与开始西他列汀治疗6个月后的数据进行比较。在2型糖尿病患者接受西他列汀治疗6个月前后的几乎相同时间点,测量体重、血压、血糖、糖化血红蛋白(HbA1c)、血脂和估算肾小球滤过率。

结果

西他列汀治疗6个月后体重显著降低0.8kg。西他列汀治疗后HbA1c水平也显著降低0.6%。我们发现体重变化与基线时的体重指数之间存在显著负相关。我们还观察到HbA1c变化与基线时的HbA1c水平之间存在显著负相关。西他列汀治疗后尿糖阴性的患者数量显著增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e482/3409620/0804fe87b906/jocmr-04-251-g001.jpg

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