西格列汀对2型糖尿病患者血糖、CD4+T细胞亚群、炎性因子及氧自由基的影响

目的探讨西格列汀对2型糖尿病(type 2 diabetes mellitus,T2DM)患者血糖、CD4+T细胞亚群、炎性因子及氧自由基的影响。方法选取初治T2DM 90例作为研究对象。采用随机数字表法随机将其分为观察组和对照组两组各45例。观察组采用西格列汀治疗,对照组采用阿卡波糖治疗,疗程均为12周。观察比较两组治疗前后血糖指标、CD4+T细胞亚群、炎性因子及氧自由基水平,以及治疗期间不良反应发生情况。结果治疗前,两组血糖指标、CD4+T细胞亚群、炎性因子及氧自由基水平比较差异均无统计学意义(P>0.05)。治疗后,两组空腹血糖(FBG)、餐后2小时血糖(2 h PG)、糖化血红蛋白(HbA1c)、稳态模型胰岛素抵抗指数(HOMA-IR),辅助性T细胞1(Th)、Th17、Th22,干扰素-γ(IFN-γ)、白细胞介素(IL)-17A、IL-22和丙二醛(MDA)、3-硝基酪氨酸(3-NT)水平均较治疗前降低,稳态模型胰岛β细胞功能指数(HOMA-β)和超氧化物歧化酶(SOD)水平均较治疗前升高,差异有统计学意义(P<0.01)。治疗后,观察组FBG、2 h PG、HbA1c、HOMA-IR,Th1、Th17、Th22,IFN-γ、IL-17A、IL-22和MDA、3-NT水平低于对照组,HOMA-β和SOD水平高于对照组,差异有统计学意义(P<0.05或P<0.01)。治疗期间,观察组无不良反应发生,对照组出现7例胃肠道反应,两组不良反应总发生率比较差异有统计学意义(P<0.05)。结论西格列汀治疗T2DM能够更好地控制血糖,改善胰岛素抵抗及胰岛β细胞功能,其作用可能与调节CD4+T细胞亚群平衡和下调IFN-γ、IL-17A、IL-22、MDA、3-NT有关。

Influence of Sitagliptin on Blood Glucose,CD4+T Cell Subsets,Inflammatory Factors and Oxygen Free Radicals in Patients with Type 2 Diabetes Mellitus

Objective To investigate the influence of Sitagliptin on blood glucose,CD4+T cell subsets,inflammatory factors and oxygen free radicals in patients with type 2 diabetes mellitus(T2DM).Methods A total of 90 patients with newly diagnosed T2DM were selected and randomly divided into observation group(n=45)and control group(n=45)according to random number table method.The observation group were treated with Sitagliptin,while the control group were treated with Acarbose,lasting for 12 weeks.The levels of blood glucose indexes,CD4+T cell subsets,inflammatory factors and oxygen free radicals before and after treatment,as well as the occurrence of adverse reactions during treatment were compared between the two groups.Results Before treatment,no significant differences were found in the levels of blood glucose,CD4+T cell subsets,inflammatory factors and oxygen free radicals between the two groups(P>0.05).After treatment,the fasting blood glucose(FBG),2-hour postprandial blood glucose(2 h PG),glycosylated hemoglobin(HbA1c),homeostasis model assessment of insulin resistance(HOMA-IR),T helper cell(Th)1,Th17,Th22,interferon-γ(IFN-γ),interleukin(IL)-17A,IL-22,malondialdehyde(MDA),and 3-nitrotyrosine(3-NT)levels were decreased in the two groups,while homeostasis model assessment beta cell function(HOMA-β)and superoxide dismutase(SOD)levels were increased(P<0.01).After treatment,the FBG,2 h PG,HbA1c,HOMA-IR,Th1,Th17,Th22,IFN-γ,IL-17A,IL-22,MDA,and 3-NT levels were lower,while HOMA-βand SOD levels were higher in the observation group than in the control group(P<0.05 or P<0.01).No adverse reactions were observed in the observation group during treatment.However,there were 7 cases of gastrointestinal reactions in the control group,suggesting that there was a significant difference in the incidence of adverse reactions between the two groups(P<0.05).Conclusion Sitagliptin applied in the treatment of T2DM can better control blood glucose,and improve insulin resistance and isletβcell function,which may be related to regulation of CD4+T cell subsets and down-regulation of IFN-γ,IL-17A,IL-22,MDA and 3-NT.