吡格列酮联合二甲双胍对初诊2型糖尿病患者血清视黄醇结合蛋白4水平的影响

目的观察吡格列酮联合二甲双胍对初诊2型糖尿病(T2DM)患者血清视黄醇结合蛋白4(RBP4)水平的影响。方法 60例初发T2DM(A组)患者随机分二组,30例予二甲双胍(A1组)和30例予吡格列酮联合二甲双胍(A2组)治疗12周,30例正常体检者为对照组(B组)。观察两组治疗前后空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、RBP4、血脂、空腹胰岛素(FIns)、体质量指数(BMI)、腰臀比(WHR)及胰岛素抵抗指数(HOMA-IR)、Homeβ细胞功能指数(HBCI)的变化。结果 (1)A组血清RBP4水平明显高于B组(P0.05);(2)A1组和A2组治疗后FPG、Hb Alc、FIns、RBP4、HOMA-IR、BMI、WHR、低密度胆固醇(LDL-C)均明显低于治疗前(P0.05)。A2组血清RBP4、HOMA-IR和LDL-C更低于A1组(P0.05)。A1组、A2组治疗后HBCI均明显高于治疗前(P0.05),两组治疗后比较差异无统计学意义(P0.05)。结论二甲双胍联合吡格列酮可更有效降低血清RBP4,更好发挥降血糖,改善胰岛素抵抗和β细胞功能的疗效。

Effect of pioglitazone combined with metformin on serum retinol-binding protein 4 (RBP4) in patients with newly diagnosed type 2 diabetes

Objective To observe the effects of pioglitazone combined with metformin on serum RBP4 level in patients with newly diagnosed type 2 diabetes mellitus(T2DM)and examine the relationship between RBP4 and T2DM, and the treatment mechanism of medicine.Methods Sixty patients with newly-diagnosed T2DM (A group)were ran-domly divided into two groups,30 cases were treated with metformin(A1 group),30 cases were treated with pioglitazone and metformin(A2 group)for 12 weeks,30 health examination clients were selected as control(B group).Fasting plas-ma glucose(FBG),glycosylated hemoglobin (HbAl c),RBP4,blood fat,fasting plasma insulin(FIns),the body mass index (BMI),the waist-hip-ratio(WHR)and HOMA-insulin resistance index (HOMA-IR),Homeβcell function index (HBCI)before the treatment.Results (1 )The serum RBP4 level of A group was higher than B group (P <0.05).(2)After the treatment, the FPG,HbAl c,FIns,RBP4,HOMA-IR,BMI,WHR,Low density lipoprotein cho-lesterol (LDL-C)were significantly decreased in A1 and A2 groups (P <0.05),and the effect of the A2 group was su-perior to that in the A1 group.HBCI was significantly increased compard with that befor treatment(P <0.05),there were no statistical differences between two groups after treatment(P >0.05).Conclusions The combined treatment with metformin and pioglitazone can decrease plasma glucose level and improve IR and β-cell function better.