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二肽基肽酶-4抑制剂对老年2型糖尿病合并轻度认知障碍患者的影响

Effect of DPP-4 inhibitor on elderly patients with T2DM combined with MCI.

作者信息

Xue Jujun, Wang Cuiqing, Pan Chengli, Xing Haining, Xu Lijuan, Chen Xi, Wang Xuping, Wang Na

机构信息

Department of Gerontological Neurology, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150001, P.R. China.

Department of Pediatric Clinic, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150001, P.R. China.

出版信息

Exp Ther Med. 2020 Feb;19(2):1356-1362. doi: 10.3892/etm.2019.8339. Epub 2019 Dec 17.

Abstract

The aim of this study was to investigate the effect of dipeptidyl peptidase-4 (DPP-4) inhibitor on blood sugar level and cognitive ability in elderly patients with type 2 diabetes mellitus (T2DM) combined with post-stroke mild cognitive impairment (MCI). Thirty patients received DPP-4 inhibitor (study group), while another thirty received sulfonylurea (control group). Six months after treatment, markers regarding blood sugar were improved in both groups (all P<0.05) without intergroup differences (all P>0.05); scores regarding cognitive ability improved in the study group (both P<0.05) and were higher versus the control group (both P<0.01); the study group had higher Aβ1-42/Aβ1-40 value versus the pretreatment value (P<0.001), which differed from the control group (P<0.05); tumor necrosis factor-α and interleukin-6 concentrations decreased in both groups, while the study group had greater reductions; C-reactive protein value decreased after treatment in the study group (all P<0.05). Using DPP-4 inhibitor in elderly patients with T2DM combined with post-stroke MCI can lower blood sugar and improve cognitive ability. The mechanism may be associated with the improvement of Aβ gathering and reduction in inflammatory response.

摘要

本研究旨在探讨二肽基肽酶-4(DPP-4)抑制剂对老年2型糖尿病(T2DM)合并卒中后轻度认知障碍(MCI)患者血糖水平及认知能力的影响。30例患者接受DPP-4抑制剂治疗(研究组),另外30例接受磺脲类药物治疗(对照组)。治疗6个月后,两组血糖相关指标均得到改善(均P<0.05),组间差异无统计学意义(均P>0.05);研究组认知能力评分改善(均P<0.05),且高于对照组(均P<0.01);研究组Aβ1-42/Aβ1-40值高于治疗前(P<0.001),与对照组相比差异有统计学意义(P<0.05);两组肿瘤坏死因子-α和白细胞介素-6浓度均降低,而研究组降低更明显;研究组治疗后C反应蛋白值降低(均P<0.05)。老年T2DM合并卒中后MCI患者使用DPP-4抑制剂可降低血糖并改善认知能力。其机制可能与改善Aβ聚集及减轻炎症反应有关。

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