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二肽基肽酶-4 抑制剂依格列汀和阿格列汀改善 2 型糖尿病患者的胰岛β细胞功能。

Dipeptidyl-Peptidase-IV Inhibitors, Imigliptin and Alogliptin, Improve Beta-Cell Function in Type 2 Diabetes.

机构信息

Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China.

Drug Clinical Trial Center, Peking University Third Hospital, Beijing, China.

出版信息

Front Endocrinol (Lausanne). 2021 Sep 20;12:694390. doi: 10.3389/fendo.2021.694390. eCollection 2021.

Abstract

OBJECTS

Imigliptin is a novel dipeptidyl peptidase-4 inhibitor. In the present study, we aimed to evaluate the effects of imigliptin and alogliptin on insulin resistance and beta-cell function in Chinese patients with type-2 diabetes mellitus (T2DM).

METHODS

A total of 37 Chinese T2DM patients were randomized to receive 25 mg imigliptin, 50 mg imigliptin, placebo, and 25 mg alogliptin (positive drug) for 13 days. Oral glucose tolerance tests were conducted at baseline and on day 13, followed by the oral minimal model (OMM).

RESULTS

Imigliptin or alogliptin treatment, compared with their baseline or placebo, was associated with higher beta-cell function parameters ( and ) and lower glucose area under the curve (AUC) and postprandial glucose levels. The changes in the AUC for the glucose appearance rate between 0 and 120 min also showed a decrease in imigliptin or alogliptin groups. However, the insulin resistance parameter, fasting glucose, was not changed. For the homeostatic model assessment (HOMA-β and HOMA-IR) parameters or secretory units of islets in transplantation index (SUIT), no statistically significant changes were found both within treatments and between treatments.

CONCLUSIONS

After 13 days of treatment, imigliptin and alogliptin could decrease glycemic levels by improving beta-cell function. By comparing OMM with HOMA or SUIT results, glucose stimulation might be more sensitive for detecting changes in beta-cell function.

摘要

目的

依格列净是一种新型二肽基肽酶-4 抑制剂。本研究旨在评估依格列净和阿格列汀对中国 2 型糖尿病(T2DM)患者胰岛素抵抗和胰岛β细胞功能的影响。

方法

37 例中国 T2DM 患者随机接受 25mg 依格列净、50mg 依格列净、安慰剂和 25mg 阿格列汀(阳性药物)治疗 13 天。在基线和第 13 天进行口服葡萄糖耐量试验,随后进行口服最小模型(OMM)分析。

结果

与基线或安慰剂相比,依格列净或阿格列汀治疗与更高的胰岛β细胞功能参数( 和 )以及更低的血糖曲线下面积(AUC)和餐后血糖水平相关。0 至 120 分钟葡萄糖出现率的 AUC 变化也显示出依格列净或阿格列汀组的下降。然而,胰岛素抵抗参数(空腹血糖)没有变化。对于稳态模型评估(HOMA-β 和 HOMA-IR)参数或胰岛移植单位指数(SUIT),在治疗内和治疗间均未发现统计学上的显著变化。

结论

治疗 13 天后,依格列净和阿格列汀可通过改善胰岛β细胞功能降低血糖水平。通过将 OMM 与 HOMA 或 SUIT 结果进行比较,葡萄糖刺激可能更敏感地检测到胰岛β细胞功能的变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1351/8488395/14a01c25b008/fendo-12-694390-g001.jpg

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