Fan Yujuan, Zhang Yu, Li Xuesong, Zheng Hui, Song Yuping, Zhang Ning, Shen Chunfang, Fan Xiaofang, Ren Fengdong, Shen Jiayi, Ren Guoguang, Yang Jialin
Department of Endocrinology, Central Hospital of Minhang District, Minhang Hospital affiliated to Fudan University, Shanghai, People's Republic of China.
Drug Des Devel Ther. 2015 Aug 14;9:4679-83. doi: 10.2147/DDDT.S85740. eCollection 2015.
The objective of this study was to assess the effects of metformin monotherapy or combined treatment with a dipeptidyl peptidase-4 inhibitor (vildagliptin) on apelin levels in patients with type 2 diabetes mellitus.
Twenty-five patients with poor glycemic control (glycosylated hemoglobin >6.5% [48 mmol/mol]) taking 1,000 mg of metformin daily and 25 healthy controls matched for age and body mass index were enrolled in this study. Anthropometric parameters, glycemic and lipid profile, insulin resistance (homeostasis model assessment of insulin resistance index), and apelin levels were measured at baseline and at 12-week and 24-week visits.
At baseline, apelin levels were higher in the T2DM patients than in the controls (1.93±1.81 ng/mL versus 6.09±4.90 ng/mL; P<0.05). After 12 weeks, when vildagliptin was added, fasting blood glucose and glycosylated hemoglobin decreased, and apelin levels increased further (from 6.09±4.90 ng/mL to 24.23±12.59 ng/mL; P<0.05). Follow-up at 24 weeks showed no further improvement in the glycemic profile and no further increase in apelin levels.
Both metformin and vildagliptin favorably changed glycemic indices and apelin levels. For patients inadequately controlled on a low dose of metformin, addition of vildagliptin may be helpful.
本研究的目的是评估二甲双胍单药治疗或与二肽基肽酶 - 4抑制剂（维格列汀）联合治疗对2型糖尿病患者阿帕elin水平的影响。
本研究纳入了25例血糖控制不佳（糖化血红蛋白>6.5% [48 mmol/mol]）且每日服用1000 mg二甲双胍的患者以及25名年龄和体重指数相匹配的健康对照者。在基线、第12周和第24周就诊时测量人体测量参数、血糖和血脂谱、胰岛素抵抗（胰岛素抵抗指数的稳态模型评估）以及阿帕elin水平。
在基线时，2型糖尿病患者的阿帕elin水平高于对照组（1.93±1.81 ng/mL对6.09±4.90 ng/mL；P<0.05）。12周后，添加维格列汀时，空腹血糖和糖化血红蛋白降低，阿帕elin水平进一步升高（从6.09±4.90 ng/mL升至24.23±12.59 ng/mL；P<0.05）。24周的随访显示血糖谱没有进一步改善，阿帕elin水平也没有进一步升高。
二甲双胍和维格列汀均能改善血糖指标和阿帕elin水平。对于低剂量二甲双胍控制不佳的患者，添加维格列汀可能会有帮助。
