Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao 266000, PR China.
Department of Cancer Radiotherapy, The Affiliated Hospital of Qingdao University, Qingdao 266000, PR China.
Life Sci. 2021 Jun 1;274:119069. doi: 10.1016/j.lfs.2021.119069. Epub 2021 Jan 15.
As a complicated metabolic disorder, type 2 diabetes mellitus (T2DM) is becoming a major health concern worldwide. Drugs including acarbose, saxagliptin and vildagliptin are applied, but their efficacy is still required to be compared. Therefore, the study aimed to evaluate the efficacy and safety of acarbose, saxagliptin and vildagliptin in the treatment of T2DM. Ninety patients diagnosed with T2DM were treated with acarbose, saxagliptin and vildagliptin, respectively (30 patients for each drug). All patients were examined at 0, 4 and 12 weeks after treatment with vital signs recorded. Fasting blood glucose and blood biochemical indices were analyzed. In addition, fecal samples were taken for microbial macrogenome sequencing and safety evaluation within 12 weeks after treatment. Blood glucose level decreased at 4 and 12 weeks after treatment, and the total cholesterol (TC) and high-density lipoprotein (HDL) levels at 12 weeks were different. Genus abundance of intestinal flora was altered at different time points. Acarbose increased Butyricimonas level first and then decreased it during drug treatment. Saxagliptin increased Megamonas and decreased Turicibacter genus level gradually. Pseudomonas, Klebsiella, Blautia, Faecalibacterium and Roseburia levels fluctuated after Vildagliptin treatment, which increased fasting C-peptide level greater than the other two drugs. Saxagliptin showed higher adverse reactions than acarbose and vildagliptin. Collectively, acarbose, vildagliptin, and saxagliptin can effectively reduce the HbA1c level and affect the intestinal flora distribution in T2DM patients, and the adverse reactions of acarbose and vildagliptin are less than saxagliptin, providing alternative strategies for the treatment of T2DM.
作为一种复杂的代谢紊乱，2 型糖尿病（T2DM）正在成为全球主要的健康关注点。包括阿卡波糖、沙格列汀和维格列汀在内的药物被应用，但它们的疗效仍需要进行比较。因此，本研究旨在评估阿卡波糖、沙格列汀和维格列汀治疗 T2DM 的疗效和安全性。90 例 T2DM 患者分别接受阿卡波糖、沙格列汀和维格列汀治疗（每组 30 例）。所有患者在治疗后 0、4 和 12 周进行生命体征检查，并分析空腹血糖和血液生化指标。此外，在治疗后 12 周内还进行了粪便样本的微生物宏基因组测序和安全性评估。治疗后 4 和 12 周时血糖水平下降，12 周时总胆固醇（TC）和高密度脂蛋白（HDL）水平不同。肠道菌群的属丰度在不同时间点发生改变。阿卡波糖在治疗过程中先增加丁酸单胞菌属水平，然后降低其水平。沙格列汀逐渐增加 Megamonas 属水平，降低 Turicibacter 属水平。维格列汀治疗后，假单胞菌属、克雷伯菌属、布劳特氏菌属、粪杆菌属和罗氏菌属水平波动，使空腹 C 肽水平升高大于其他两种药物。沙格列汀的不良反应发生率高于阿卡波糖和维格列汀。综上所述，阿卡波糖、维格列汀和沙格列汀均可有效降低 T2DM 患者的 HbA1c 水平，并影响肠道菌群分布，阿卡波糖和维格列汀的不良反应发生率低于沙格列汀，为 T2DM 的治疗提供了替代策略。
