埃索美拉唑治疗后高胃泌素血症对 2 型糖尿病控制良好患者的短期影响：一项前瞻性研究。

Short-Term Effect of Hypergastrinemia Following Esomeprazole Treatment On Well-Controlled Type 2 Diabetes Mellitus: A Prospective Study.

机构信息

Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, Ankara, Turkey.

出版信息

Endocr Metab Immune Disord Drug Targets. 2020;20(7):1090-1096. doi: 10.2174/1871530320666200129124555.

DOI:10.2174/1871530320666200129124555

PMID:31995024

Abstract

OBJECTIVE

Proton pump inhibitor (PPI) drugs reduce gastric acid secretion and lead to an increase in serum gastrin levels. Many preclinical and some clinical researches have established some positive effects of gastrin or PPI therapy on glucose regulation. The aim of this study was to prospectively investigate the short term effects of esomeprazole on glycaemic control in patients with type 2 diabetes mellitus. In addition, the presence of an association between this effect and gastrin levels was evaluated.

METHODS

Thirty-two subjects with type 2 diabetes mellitus were enrolled and grouped as intervention (n=16) and control (n=16). The participants in the intervention group were prescribed 40 mg of esomeprazole treatment for three months. At the beginning of the study and at the 3rd month, HbA1c level (%) and gastrin levels (pmol/L) of participants were assessed. Then, the groups were compared in terms of their baseline and 3rd month values.

RESULTS

In the intervention group, the mean gastrin level increased significantly from 34.3±14.4 pmol/L to 87.4±43.6 pmol/L (p<0.001). The mean HbA1c level was similar to the pre-treatment level (6.3±0.7% vs. 6.4±0.9%, p=0.441). There were no statistically significant differences in all parameters of the control group. The majority of individuals were on metformin monotherapy (65.6 %). The subgroup analysis of metformin monotherapy revealed that, in intervention group, there was a significant increase in gastrin levels (39.9±12.6 vs. 95.5±52.5, p=0.026), but the HbA1c levels did not change (6.0±0.4 % vs. 5.9±0.6 %, p=0.288); and in control group, gastrin levels did not change (37.5 ± 26.7 vs. 36.1 ±23.3, p=0.367), but there was an increase in HbA1c levels (6.1 ± 0.50 vs. 6.4 ± 0.60, p=0.01).

CONCLUSION

Our study demonstrates that esomeprazole has no extra benefit for the controlled diabetic patient in three months. However, in only the metformin-treated subgroup, esomeprazole may prevent the rise in HbA1c level.

摘要

目的

质子泵抑制剂（PPI）药物可减少胃酸分泌，导致血清胃泌素水平升高。许多临床前和一些临床研究已经证实胃泌素或 PPI 治疗对葡萄糖调节有一些积极作用。本研究的目的是前瞻性研究埃索美拉唑对 2 型糖尿病患者血糖控制的短期影响。此外，还评估了这种作用与胃泌素水平之间的关系。

方法

纳入 32 例 2 型糖尿病患者，并分为干预组（n=16）和对照组（n=16）。干预组患者接受 40mg 埃索美拉唑治疗 3 个月。在研究开始时和第 3 个月，评估参与者的糖化血红蛋白（HbA1c）水平（%）和胃泌素水平（pmol/L）。然后，比较两组的基线和第 3 个月的值。

结果

在干预组中，胃泌素水平从 34.3±14.4pmol/L 显著升高至 87.4±43.6pmol/L（p<0.001）。平均 HbA1c 水平与治疗前水平相似（6.3±0.7% vs. 6.4±0.9%，p=0.441）。对照组的所有参数均无统计学差异。大多数患者接受二甲双胍单药治疗（65.6%）。二甲双胍单药治疗的亚组分析显示，干预组胃泌素水平显著升高（39.9±12.6 vs. 95.5±52.5，p=0.026），但 HbA1c 水平无变化（6.0±0.4% vs. 5.9±0.6%，p=0.288）；而对照组胃泌素水平无变化（37.5±26.7 vs. 36.1±23.3，p=0.367），但 HbA1c 水平升高（6.1±0.50 vs. 6.4±0.60，p=0.01）。