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首页> 外文期刊>Journal of Clinical Medicine Research >Effects of Sitagliptin on Pancreatic Beta-Cells in Type 2 Diabetes With Sulfonylurea Treatment: A Prospective Randomized Study
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Effects of Sitagliptin on Pancreatic Beta-Cells in Type 2 Diabetes With Sulfonylurea Treatment: A Prospective Randomized Study

机译：西他列汀对磺脲类药物治疗2型糖尿病胰腺β细胞的影响：一项前瞻性随机研究

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Background: This prospective randomized, multicenter, open-label, comparative study was performed to analyze the effects of sitagliptin on glycemic control and maintenance of beta-cell function in patients with poorly controlled type 2 diabetes treated with low-dose glimepiride. Methods: Forty-one patients with type 2 diabetes mellitus treated with low-dose glimepiride (≤ 2 mg/day) were prospectively enrolled in this study (age: 20 - 75 years; hemoglobin A1c (HbA1c): 7.4- 9.4%). The patients were randomized into two groups: the glimepiride (G) group, in which glimepiride dose was increased gradually to 6 mg/day, and the sitagliptin (S) group, in which sitagliptin was added at a dose of 50 mg/day. Results: HbA1c level was significantly decreased after 24 weeks, but not 12 weeks, in the G group, while a significant decrease was seen after 12 weeks in the S group. Although there were no significant differences in HbA1c level at 24 weeks between the two groups (P = 0.057). The overall trend of changes in HbA1c level suggested that the glucose-lowering effects were superior in the S group. Furthermore, a significant change in fasting glucose was seen in the S group, but not in the G group. Glycemic control target was achieved in 36.7% and 16.7% patients in the S group and the G group, respectively. The proinsulin/insulin (P/I) ratio was significantly increased in the G group, whereas it tended to decrease in the S group. After 24 weeks of treatment, no significant difference was observed in the P/I ratio between the two groups, whereas a significant difference was noted in the ΔP/I (amount of change). Albuminuria tended to increase in the G group compared with the S group. Conclusion: The results of the present study suggested that sitagliptin effectively lowered hyperglycemia and that it may have a protective effect on pancreatic beta-cells when combined with a low dose of glimepiride. Therefore, sitagliptin may represent a useful combination therapy with low-dose sulfonylurea, not only for achieving glycemic control but also for protection of pancreatic beta-cells.
机译：背景：这项前瞻性，随机，多中心，开放标签的对比研究旨在分析西他列汀对低剂量格列美脲治疗效果欠佳的2型糖尿病患者的血糖控制和β细胞功能维持的影响。方法：前瞻性纳入了接受低剂量格列美脲治疗（≤2 mg /天）的2型2型糖尿病患者（年龄：20-75岁;血红蛋白A1c（HbA1c）：7.4-9.4％）。将患者随机分为两组：格列美脲（G）组，其中格列美脲剂量逐渐增加至6 mg /天;西他列汀（S）组，其中西他列汀以50 mg /天的剂量添加。结果：G组的HbA1c水平在24周后显着下降，但在12周时没有下降，而S组在12周后发现显着下降。两组之间在24周时HbA1c水平没有显着差异（P = 0.057）。 HbA1c水平的总体变化趋势表明，S组的降糖效果更好。此外，在S组中观察到空腹血糖有显着变化，而在G组中则没有。 S组和G组分别达到36.7％和16.7％的患者血糖控制目标。 G组中胰岛素原/胰岛素（P / I）比例显着增加，而S组则倾向于降低。治疗24周后，两组之间的P / I比例均无明显差异，而ΔP/ I（变化量）却有显着差异。与S组相比，G组蛋白尿趋于增加。结论：本研究结果表明西他列汀可有效降低高血糖症，并与低剂量格列美脲联合使用可能对胰腺β细胞具有保护作用。因此，西他列汀可能代表一种与低剂量磺酰脲类药物的有效联合疗法，不仅可以实现血糖控制，而且还可以保护胰腺β细胞。

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