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比较曲格列汀和西他列汀对 2 型糖尿病患者视黄醇结合蛋白 4 水平的影响及其与胰岛素抵抗的相关性。

Comparative Evaluation of Chiglitazar and Sitagliptin on the Levels of Retinol-Binding Protein 4 and Its Correlation With Insulin Resistance in Patients With Type 2 Diabetes.

机构信息

Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.

Department of Cadre Gastroenterology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.

出版信息

Front Endocrinol (Lausanne). 2022 Apr 25;13:801271. doi: 10.3389/fendo.2022.801271. eCollection 2022.

Abstract

AIMS

We evaluated the efficacy and significant changes in the levels of retinol-binding protein 4 (RBP-4) and insulin resistance in patients with type 2 diabetes mellitus (T2DM) treated with chiglitazar versus sitagliptin.

METHODS

Eighty-one T2DM patients with haemoglobin A1c (HbA1c) level of 7.5%-10.0% were selected. Based on the study criteria, patients were randomly assigned to receive chiglitazar (32 mg), chiglitazar (48 mg), or sitagliptin (100 mg) orally for 24 weeks. Sociodemographic and anthropometric characteristics, lipid profiles, glucose profiles, and serum RBP-4 levels were determined at baseline and at the end of the therapy.

RESULTS

After treatment for 24 weeks, significant changes in fasting blood glucose (FBG), fasting insulin (Fins), 2 h-blood glucose (2h-BG), the score values of insulin resistance/insulin secretion/β cell function (HOMA-IR, HOMA-IS, and HOMA-β), triglyceride (TG), free fatty acid (FFA), high-density lipoprotein cholesterol (HDL-C), and RBP-4 levels were detected in patients with chiglitazar administration and sitagliptin administration. Changes in RBP-4 levels were positively correlated with changes in HOMA-IR and 2 h-BG in linear regression.

CONCLUSIONS

Chiglitazar showed a greater improvement in parameters of diabetes than sitagliptin, and changes in serum RBP-4 levels were associated with changes in insulin-sensitizing parameters.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, CT.gov identifier: NCT02173457.

摘要

目的

我们评估了曲格列酮与西他列汀治疗 2 型糖尿病(T2DM)患者的疗效及视黄醇结合蛋白 4(RBP-4)水平的显著变化。

方法

选择 81 例糖化血红蛋白(HbA1c)水平为 7.5%-10.0%的 T2DM 患者。根据研究标准,患者被随机分为三组,分别接受曲格列酮(32 mg)、曲格列酮(48 mg)或西他列汀(100 mg)口服治疗 24 周。在基线和治疗结束时,测定患者的社会人口统计学和人体测量特征、血脂谱、血糖谱和血清 RBP-4 水平。

结果

治疗 24 周后,曲格列酮组和西他列汀组患者的空腹血糖(FBG)、空腹胰岛素(Fins)、2 小时血糖(2h-BG)、胰岛素抵抗/胰岛素分泌/β细胞功能评分值(HOMA-IR、HOMA-IS 和 HOMA-β)、三酰甘油(TG)、游离脂肪酸(FFA)、高密度脂蛋白胆固醇(HDL-C)和 RBP-4 水平均有显著变化。线性回归分析显示,RBP-4 水平的变化与 HOMA-IR 和 2h-BG 的变化呈正相关。

结论

曲格列酮在改善糖尿病参数方面优于西他列汀,血清 RBP-4 水平的变化与胰岛素增敏参数的变化有关。

临床试验注册

ClinicalTrials.gov,CT.gov 标识符:NCT02173457。

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