Division of Clinical Research, Biomedical Center, Tokyo, Japan.
Division of Diabetes and Endocrinology, Department of Internal Medicine, Gyoda General Hospital, Saitama, Japan.
Hosp Pract (1995). 2021 Apr;49(2):71-78. doi: 10.1080/21548331.2020.1847905. Epub 2020 Nov 30.
: 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.
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。