吡格列酮对2型糖尿病肾病血清脂联素水平的影响

目的观察噻唑烷二酮衍生物吡格列酮对2型糖尿病肾病患者血清脂联素水平的影响,并探讨其临床意义。方法临床选择研究2型糖尿病肾病52例,分为糖尿病肾病对照组(29例)和吡格列酮治疗组(23例)。所有患者均给予口服降糖药或胰岛素控制血糖常规治疗,待血糖稳定1周后,对照组继续维持原治疗,吡格列酮治疗组加用吡格列酮片口服8周(30mg/日)。各组治疗前后均测定空腹血糖(FPG)、糖化血红蛋白(HbA1c)、24h尿白蛋白定量(24hUA)、高敏C-反应蛋白(hs-CRP)和脂联素水平。结果①糖尿病肾病对照组与吡格列酮治疗组对比,治疗前FPG、HbA1c、24hUA、hs-CRP和脂联素水平均无明显差别,差异无统计学意义(P﹥0.05)。②治疗8周后,糖尿病肾病对照组的24hUA、hs-CRP和脂联素水平与治疗前对比无明显改变,差异无统计学意义(P﹥0.05),但是吡格列酮治疗组的24hUA、hs-CRP和脂联素水平却明显下降,差异有统计学意义(P﹤0.05)。结论噻唑烷二酮衍生物能够降低2型糖尿病肾病患者的脂联素水平,改善糖尿病的肾脏损害,减少尿白蛋白滤过。

Effect of pioglitazone on serum adiponectin in patients with type 2 diabetic nephropathy

OBJECTIVE To observe the change of pioglitazone on serum adiponectin in patients with type 2 diabetic nephropathy. METHODS We chose 52 patients with type 2 diabetic nephropathy and divided them into two groups:diabetic nephropathy control group(DN group,n=29)and pioglitazone treatment group(pioglitazone group,n=23). All patients were treated with oral hypoglycemic agents or insulin to control blood sugar level. After blood sugar level remained stable for one week,the DN group continued to maintain the original treatment,and the pioglitazone group was additional oral pioglitazone tablet for 8 weeks(30mg/day). Fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),24 hour urinary albumin quantitative(24h UA),high-sensitivity C-reactive protein(hs-CRP)and adiponectin levels were measured before and after treatment in each group. RESULTS ① There was no significant difference in FPG,HbA1c,24h UA,hs-CRP and adiponectin level between the DN group and the pioglitazone group before treatment(P﹥0.05). ②Although there was no significant change in 24h UA,hs-CRP and adiponectin level before and after treatment in the DN group,all of them significantly decreased in the pioglitazone goup after treatment with pioglitazone for 8 weeks(P﹤0.05). CONCLUSION Thiazolidinediones can decrease adiponectin level,alleviate damage on kidney and reduce urinary albumin filtration in the patients with type 2 diabetic nephropathy.