吡格列酮与二甲双胍对初诊肥胖2型糖尿病患者血清内脏脂肪素影响的研究

目的观察吡格列酮与二甲双胍对初诊肥胖T2DM患者血清内脏脂肪素（visfatin）水平的影响，探讨visfatin与T2DM发病的关系和药物的治疗机制。方法100例初诊肥胖T2DM患者随机分为吡格列酮组50例，每日口服盐酸吡格列酮片30mg，二甲双胍组50例，每日早晚口服二甲双胍缓释片500mg，疗程24周。结果吡格列酮组空腹血清visfatin、IR、TG较用药前明显降低，B细胞功能有改善（P〈0．05或P〈0．01）。二甲双胍组血清visfatin、TG无统计学改变。两组治疗后比较，吡格列酮组的visfatin、IR、TG降低明显，差异有统计学意义（P〈0．05或〈0．01），但二甲双胍组的BMI较吡格列酮组下降更明显（P〈0．05）。结论对初诊肥胖T2DM患者吡格列酮与二甲双胍均能较好地控制血糖，吡格列酮还能明显降低血清visfatin的水平，提示吡格列酮通过下调visfatin水平发挥抗炎作用。

Effect of pioglitazone and metformin on visfatin in obese patients with newly diagnosed type 2 diabetes mellitus

Objective To research the effects of pioglitazone or metformin on visfatin in obese patients with type 2 diabetes mellitus. Methods 100 type 2 diabetic obese patients were treated for 24 weeks and randomized into two groups. The subjects in pioglitazone group received piolitazone 30 mg daily. The subjects in metformin group received metformin 500 mg twice daily. Results After treatment with pioglitazone, the fasting plasma visfatin, the insulin resistance and triglyceride were decreased（P〈0.01 ,〈0.05,〈0.05 respectively）, and HOMA-β was increased（P〈0.05）. The levels of visfatin and triglyceride in the metformin group were not changed（P〈0.05）. Meanwhile, in pioglitazone group, the visfatin,insulin resistance and triglyceride were decreased obviously, and the function of β-cell was somewhat improved, which did not occur in metformin group. But the body mass index was more decreased in metformin group than in pioglitazone group（P〈0.05）. Conclusions Both pioglitazone and metformin can decrease the fasting plasma glucose and glycosylated hemoglobin. Also, pioglitazone can decrease the blood visfatin, which shows that pioglitazone has anti-inflammatory effects and can interfere the development of type 2 diabetes mellitus.