沙格列汀对新诊断的糖尿病前期肥胖患者血糖稳态及身体成分的影响。
Effects of saxagliptin on glucose homeostasis and body composition of obese patients with newly diagnosed pre-diabetes.
作者信息
Wang Zixuan, Xu Dengcheng, Huang Lanhui, Zhang Tiantian, Wang Junqiao, Chen Qing, Kong Lei, Zhou Xinli
机构信息
Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 324 Jing 5 Road, Jinan, Shandong, China.
Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 324 Jing 5 Road, Jinan, Shandong, China; Department of Endocrinology, The People's Hospital of Rizhao, Rizhao, Shandong, China.
出版信息
Diabetes Res Clin Pract. 2017 Aug;130:77-85. doi: 10.1016/j.diabres.2017.05.012. Epub 2017 May 12.
AIMS
To assess the effect of saxagliptin monotherapy on blood glucose and islet β-cell function in obese patients with newly diagnosed pre-diabetes and abnormal fat metabolism.
METHODS
A 24-week, randomized controlled trial was conducted involving 25 obese subjects with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) (mean age 45years) to receive lifestyle intervention only (control group) or combined with saxagliptin 2.5mg or 5mg daily (S2.5 or S5 group), metformin 1500mg daily (Met group). Anthropometrics, body fat and biochemical parameters were measured before and after 4, 12 and 24weeks intervention.
RESULTS
S5 group and Met group showed a significant decrease in fasting plasma glucose (FPG) and HbA1c compared with the control group (all P<0.05) after 24-week intervention. However, the decrease in 2h postprandial plasma glucose levels (2hPPG) in S5 group were greater compared with control group (P<0.01). Insulin resistance (HOMA-IR) was reduced in S5 group, Met group and control group (P<0.05), and the β-cell function (HOMA-β) was improved in all groups (P<0.05). However, the changes in obesity-related indicators including waist circumference, hip circumference, weight, BMI, body fat, percentage of body fat and waist-to-hip fat ratio were greate in Met group (all P<0.05) compared with other groups (P>0.05).
CONCLUSIONS
Saxagliptin monotherapy may prevent or delay the progression of IGT or IFG to type 2 diabetes mellitus in obese patients with newly diagnosed pre-diabetes. ClinicalTrials.gov: NCT01960205.
目的
评估沙格列汀单药治疗对新诊断的糖尿病前期且脂肪代谢异常的肥胖患者血糖及胰岛β细胞功能的影响。
方法
进行了一项为期24周的随机对照试验，纳入25例空腹血糖受损（IFG）和/或糖耐量受损（IGT）的肥胖受试者（平均年龄45岁），分别给予单纯生活方式干预（对照组），或联合每日2.5mg或5mg沙格列汀（S2.5或S5组），或每日1500mg二甲双胍（Met组）。在干预4周、12周和24周前后测量人体测量学指标、体脂和生化参数。
结果
24周干预后，S5组和Met组空腹血糖（FPG）和糖化血红蛋白（HbA1c）较对照组显著降低（均P<0.05）。然而，S5组餐后2小时血糖水平（2hPPG）下降幅度大于对照组（P<0.01）。S5组、Met组和对照组胰岛素抵抗（HOMA-IR）均降低（P<0.05），所有组的β细胞功能（HOMA-β）均得到改善（P<0.05）。然而，与其他组相比（P>0.05），Met组肥胖相关指标包括腰围、臀围、体重、BMI、体脂、体脂百分比和腰臀比变化更大（均P<0.05）。
结论
沙格列汀单药治疗可能预防或延缓新诊断的糖尿病前期肥胖患者的IGT或IFG进展为2型糖尿病。ClinicalTrials.gov：NCT01960205。
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