Department of Endocrinology, Beijing University of Chinese Medicine, Third Affiliated Hospital, Beijing, China.
Eur Rev Med Pharmacol Sci. 2017 Aug;21(15):3490-3495.
The objective of the present study was to observe the effect of sitagliptin on obese patients with insulin treatment-induced diabetes mellitus.
A total of 120 obese patients with insulin treatment-induced diabetes mellitus were consecutively selected and divided into the control group (n=35), observation group 1 (n=40), and observation group 2 (n=45). The control group received different types or doses of insulin, observation group 1 received insulin combined with metformin, and observation group 2 received insulin combined with sitagliptin. The therapeutic effects were compared at the 6-month follow-up visit.
Body mass index (BMI) was lower in observation group 1 and observation group 2, and higher in the control group compared with before treatment; the occurrence of hypoglycemia in observation group 2 was lower than in the other two groups, and the differences were statistically significant (p<0.05). After treatment, the fasting insulin (FINS) and homeostatic model assessment insulin-resistance (HOMA-IR) in observation group 2 were significantly lower than in the other two groups (p<0.05). Adiponectin levels were increased and leptin and visfatin levels were decreased in observation group 2 after treatment, and the differences were statistically significant (p<0.05). The levels of fasting blood glucose, hemoglobin A1c, total cholesterol, triglyceride, and low-density lipoprotein in the three groups were not significantly different (p>0.05).
Sitagliptin can reduce BMI and the occurrence of hypoglycemia in obese patients with insulin treatment-induced diabetes mellitus, and the effect may be related to decreased HOMA-IR, decreased leptin and visfatin levels, and increased adiponectin levels.
本研究旨在观察西格列汀对接受胰岛素治疗的肥胖 2 型糖尿病患者的影响。
连续选择 120 例接受胰岛素治疗的肥胖 2 型糖尿病患者，分为对照组（n=35）、观察组 1（n=40）和观察组 2（n=45）。对照组给予不同类型或剂量的胰岛素，观察组 1 给予胰岛素联合二甲双胍，观察组 2 给予胰岛素联合西格列汀。在 6 个月的随访时比较治疗效果。
观察组 1 和观察组 2 的体重指数（BMI）较治疗前降低，对照组较治疗前升高；观察组 2 低血糖的发生率低于其他两组，差异有统计学意义（p<0.05）。治疗后，观察组 2 的空腹胰岛素（FINS）和稳态模型评估胰岛素抵抗（HOMA-IR）均明显低于其他两组（p<0.05）。治疗后观察组 2 的脂联素水平升高，瘦素和内脂素水平降低，差异有统计学意义（p<0.05）。三组患者的空腹血糖、糖化血红蛋白、总胆固醇、三酰甘油和低密度脂蛋白水平差异均无统计学意义（p>0.05）。
西格列汀可降低接受胰岛素治疗的肥胖 2 型糖尿病患者的 BMI 和低血糖发生率，其作用可能与降低 HOMA-IR、降低瘦素和内脂素水平以及升高脂联素水平有关。
