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2型糖尿病患者应用西格列汀的抗动脉粥样硬化效应

  

  1. 1.北京市海淀医院 心内科, 北京 100080; 2.北京大学第三医院 老年内科,北京  100191
  • 出版日期:2016-09-05 发布日期:2016-08-31
  • 通讯作者: 通信作者:郭云飞,Email: 13520234261@163.com

Antiatherosclerosis effect of sitagliptin in patients with type 2 diabetes mellitus

  1. 1.Department of Cardiology, Beijing Haidian Hospital, Beijing 100080, China;
    2.Department of Geriatric Medicine,  Peking University Third Hospital, Beijing 100191, China
  • Online:2016-09-05 Published:2016-08-31
  • Contact: Corresponding author: Guo Yunfei,Email: 13520234261@163.com

摘要: 目的探讨口服降糖药物二肽基肽酶4(DPP4)抑制剂西格列汀对接受胰岛素治疗的2型糖尿病患者颈动脉内膜中层厚度(IMT)的影响。方法本研究是一个前瞻性、随机、平行对照研究。接受胰岛素治疗后血糖控制不良的2型糖尿病患者172例,分为西格列汀治疗组84例和对照组88例,通过颈动脉超声评价治疗后12个月平均IMT变化。结果随访12个月后,西格列汀组IMT较基线明显降低,而对照组无明显变化。西格列汀组IMT较对照组明显降低(P<0.05)。同时,西格列汀组降糖效应优于对照组(P<0.05),而且低血糖和体质量增加等不良事件未见增多。结论对于接受胰岛素治疗的2型糖尿病患者,加用西格列汀治疗降低血糖同时可抑制颈动脉IMT进展。

关键词: 糖尿病, 2型;动脉粥样硬化;二肽基肽酶Ⅳ抑制剂;颈动脉内膜中膜厚度

Abstract: ObjectiveTo explore the effect of sitagliptin, a dipeptidyl peptidase 4 inhibitor, on carotid intimamedia thickness (IMT)in insulintreated patients with type 2 diabetes mellitus (T2DM). MethodsThis prospective, randomized, parallel group and comparative study included 172 insulintreated patients with T2DM who were randomly allocated to either the sitagliptin group (n=84) or the control group (n=88). The primary outcomes were changes in mean IMT of the carotid artery measured by echography at the end of a 12months′  treatment. ResultsChanges in the mean IMT of the carotid arteries were significantly greater after sitagliptin treatment compared with conventional treatment (P<0.05). After followup of 12 months, sitagliptin, but not conventional treatment, significantly reduced the mean IMT of carotid arteries relative to the baseline. Sitagliptin had a more potent glucoselowering effect compared with the conventional treatment (P<0.05), without increasing hypoglycemic episodes or body mass. ConclusionSitagliptin attenuated the progression of carotid IMT in insulintreated T2DM patients with glucoselowering effect.

Key words: diabetes mellitus, type 2; atherosclerosis;dipeptidylpeptidase Ⅳ inhibitors;carotid intimamedia , thickness