Dawood Moatamad Hanoon, Abdulridha Manal Khalid, Qasim Hayder Saadoon
Department of Clinical Pharmacy, College of Pharmacy, Mustansiriyah University, Baghdad, Iraq.
Department of Medicine, College of Medicine, Maysan University, Maysan, Iraq.
J Med Life. 2023 Oct;16(10):1474-1481. doi: 10.25122/jml-2023-0178.
Pyridoxal-5-phosphate (PLP) is the bioactive derivative of vitamin B6, functioning as a coenzyme in over 150 metabolic pathways. Insufficient PLP levels could be associated with the onset and progression of diabetes. This study aimed to assess the effects of pyridoxine adjuvant treatment on blood glucose levels in patients with type 2 diabetes mellitus (T2DM). This interventional, randomized, open-label study was conducted in the Mesan Governorate, with participants from the Mesan Center for Diabetes and Endocrinology as the study population. This study included patients newly diagnosed with T2DM. Patients were randomized into three groups: Group 1, the control group, treated with non-pharmacological therapy (lifestyle modification) (n=20); Group 2, treated with Metformin 500 mg/day in addition to non-pharmacological therapy (lifestyle modification) (n=20). Group 3 was treated with Metformin 500 mg/day plus vitamin B6 300 mg/day in addition to non-pharmacological therapy (lifestyle modification) (n=68). The findings revealed a considerably favorable impact of pyridoxine adjuvant treatment with Metformin on blood glucose levels and other study variables. Compared to the patients in the control group G1, the reductions in fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) were statistically significant in groups G2 and G3 after a 4-week treatment period. Similar results were observed for fasting serum insulin and homeostasis model assessment of insulin resistance (HOMA-IR) levels, with a significant decrease in groups G2 and G3 (p<0.05). Furthermore, the reductions in indoleamine 2,3-dioxygenase levels were also significantly higher in groups G2 and G3 at the end of the 4-week treatment period (-14.48% -21.16%) (p<0.05). Adding pyridoxine adjuvant therapy to Metformin treatment could effectively improve the blood glucose levels of patients with T2DM.
磷酸吡哆醛（PLP）是维生素B6的生物活性衍生物，在150多条代谢途径中作为辅酶发挥作用。PLP水平不足可能与糖尿病的发生和发展有关。本研究旨在评估吡哆醇辅助治疗对2型糖尿病（T2DM）患者血糖水平的影响。这项干预性、随机、开放标签研究在迈桑省进行，以迈桑糖尿病和内分泌中心的参与者作为研究人群。本研究纳入新诊断的T2DM患者。患者被随机分为三组：第1组为对照组，采用非药物治疗（生活方式改变）（n = 20）；第2组，除非药物治疗（生活方式改变）外，每天服用500毫克二甲双胍（n = 20）。第3组除非药物治疗（生活方式改变）外，每天服用500毫克二甲双胍加300毫克维生素B6（n = 68）。研究结果显示，吡哆醇与二甲双胍联合辅助治疗对血糖水平和其他研究变量有相当有利的影响。与对照组G1的患者相比，在4周治疗期后，G2组和G3组的空腹血糖（FPG）和糖化血红蛋白（HbA1c）降低具有统计学意义。空腹血清胰岛素和胰岛素抵抗稳态模型评估（HOMA-IR）水平也观察到类似结果，G2组和G3组显著降低（p<0.05）。此外，在4周治疗期结束时，G2组和G3组的吲哚胺2,3-双加氧酶水平降低也显著更高（-14.48% -21.16%）（p<0.05）。在二甲双胍治疗中添加吡哆醇辅助治疗可有效改善T2DM患者的血糖水平。
