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在未经药物治疗的 2 型糖尿病患者中,西格列汀治疗与血清尿酸和胰岛β细胞功能之间的关系。

Link between serum uric acid and pancreatic beta-cell function in drug naïve subjects with type 2 diabetes treated with sitagliptin.

机构信息

Division of Clinical Research, Biomedical Center, Tokyo, Japan.

Division of Diabetes and Endocrinology, Department of Internal Medicine, Gyoda General Hospital, Saitama, Japan.

出版信息

Hosp Pract (1995). 2021 Apr;49(2):71-78. doi: 10.1080/21548331.2020.1847905. Epub 2020 Nov 30.

Abstract

: The objective of this study is to investigate the changes of UA with sitagliptin in relation to its glycemic/non-glycemic efficacies.: Drug naïve subjects with T2DM (n = 62) were administered 25-50 mg/day sitagliptin monotherapy for 3 months. The subjects were divided into two subgroups according to the changes in (Δ) UA (above the median [group A, n = 31]: ΔUA = 23.3%, p < 0.00001, and below the median [group B, n = 31]: ΔUA = -0.9%, n.s.). Changes in glycemic/non-glycemic parameters were compared between these two groups, which acted as a control for each other.: In the overall subjects, UA significantly increased (10.8%, p < 0.00001). Significant correlations between ΔUA and ΔBMI (R = 0.252), ΔHOMA-B (R = 0.309) or ΔCPR-index (R = 0.258), and significant negative correlations between ΔUA and ΔHbA1c (R = -0.290) or ΔFFA (R = -0.271) were seen. Between group A and group B, some parameters displayed distinct regulatory patterns. HbA1c significantly decreased in both groups (group A: from 9.97% to 7.65%, group B: from 10.41% to 8.85%) with significant inter-group differences (higher reductions in group A, p < 0.05). C-peptide (+10.6%) and BMI (+1.7%) significantly increased, and FFA (-20.5%) decreased in group A. HOMA-R or 20/(C-peptide x FBG) had no changes in either group, while HOMA-B (group A: +85.1%, group B: +38.8%) or CPR-index (group A: +37.7%, group B: +20.5%) increased in both groups with significant inter-group differences (both p < 0.01). TG (-18.8%) significantly decreased, and T-C (-3.5%) and non-HDL-C (-4%) had a tendency to decrease in group B.: These results suggest that UA and beta-cell functions/glycemic efficacy are closely linked during sitagliptin therapy. Those with elevated UA had better beta-cell enhancing and glyemic efficacies. Body weights increased and FFA decreased in these populations. By contrast, those without changes in UA had favorable profiles in atherogenic lipids.

摘要

这项研究的目的是探讨西格列汀在与血糖/非血糖疗效相关的情况下尿酸(UA)的变化。

62 例 T2DM 初治患者接受西格列汀 25-50mg/天单药治疗 3 个月。根据 UA 的变化(高于中位数[组 A,n=31]:ΔUA=23.3%,p<0.00001,低于中位数[组 B,n=31]:ΔUA=-0.9%,n.s.)将患者分为两组。比较两组之间血糖/非血糖参数的变化,互为对照。

在所有患者中,UA 显著升高(10.8%,p<0.00001)。ΔUA 与 ΔBMI(R=0.252)、ΔHOMA-B(R=0.309)或 ΔCPR-index(R=0.258)之间存在显著相关性,与 ΔHbA1c(R=-0.290)或 ΔFFA(R=-0.271)之间存在显著负相关性。在组 A 和组 B 之间,一些参数显示出明显的调节模式。两组的 HbA1c 均显著降低(组 A:从 9.97%降至 7.65%,组 B:从 10.41%降至 8.85%),组间差异有统计学意义(组 A 降低更显著,p<0.05)。C 肽(+10.6%)和 BMI(+1.7%)显著升高,FFA(-20.5%)降低。组内 HOMA-R 或 20/(C 肽×FBG)无变化,而组内 HOMA-B(组 A:+85.1%,组 B:+38.8%)或 CPR-index(组 A:+37.7%,组 B:+20.5%)均升高,组间差异有统计学意义(均 p<0.01)。TG(-18.8%)显著降低,T-C(-3.5%)和非 HDL-C(-4%)呈降低趋势。

这些结果表明,在西格列汀治疗期间,UA 和胰岛β细胞功能/血糖疗效密切相关。UA 升高者β细胞增强和血糖疗效更好。这些人群的体重增加,FFA 减少。相反,UA 无变化者的动脉粥样硬化脂质指标良好。

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