瑞格列奈和格列齐特缓释片对新诊断2型糖尿病患者血清非对称性二甲基精氨酸的影响

Effect of repaglinide and gliclazide MR on serum asymmetric dimethylarginine in patients with newly diagnosed #br# type 2 diabetes mellitus

摘要:

目的  比较瑞格列奈和格列齐特缓释片对新诊断2型糖尿病餐后血糖、血清真胰岛素、非对称性二甲基精氨酸水平的影响。方法  新诊断2型糖尿病患者40例随机分为瑞格列奈组和格列齐特缓释片组，进行为期4周的随机平行对照研究，两种药物治疗前后测定空腹和标准餐后血糖、血清真胰岛素和非对称性二甲基精氨酸水平，并用早期胰岛素分泌指数评价早相胰岛素分泌功能。结果  瑞格列奈和格列齐特缓释片降低餐后血糖的效果相似；瑞格列奈较格列齐特缓释片显著改善早期胰岛素分泌指数（P =0.018）；瑞格列奈能显著降低餐后240 min血清非对称性二甲基精氨酸水平（P =0.012）；格列齐特缓释片能显著降低餐后180 min（P =0.014）和240 min血清非对称性二甲基精氨酸水平（P =0.002）。结论  瑞格列奈和格列齐特缓释片对新诊断的2型糖尿病患者的总降糖效果相当；瑞格列奈可改善早相胰岛素分泌，其作用强于格列齐特缓释片；瑞格列奈和格列齐特缓释片均能降低餐后血清非对称性二甲基精氨酸水平，提示这两种促泌剂在改善2型糖尿病患者血管内皮功能障碍，延缓其大血管并发症发生和发展方面有一定作用。

Abstract:

Objective To investigate the effects of repaglinide (Rg) versus gliclazide (Gli) on the levels of postprandial glucose, serum true insulin and asymmetric dimethylarginine (ADMA) in patients with newly diagnosed type 2 diabetes. Methods An open-labelled parallel studies of Rg or Gli MR was conducted on 40 newly diagnosed type 2 diabetes petients during a period of 4 weeks. Plasma glucose (PG), serum true insulin and ADMA levels at fasting and after a standard meal were measured before and after treatment with both agents. Early-phase insulin secretion was assessed using early-phase insulin secretion index (ΔI30/ΔG30). Results The effects of Rg and Gli on postprandial hyperglycemia in patients with type 2 diabetes were similar. Early-phase insulin secretion index (ΔI30/ΔG30) increased significantly in both groups (P < 0.05) and with a stroger response especially in Rg group (P = 0.018 vs. Gli). Both postprandial 240 min ADMA in Rg group (P = 0.012) and 180 min (P = 0.014) and 240 min (P = 0.002) ADMA in Gli group decreased significantly. Conclusions Treatment with Rg is associated with a greater improvement in early-phase insulin secretion. Both Rg and Gli can reduce postprandial ADMA level, which suggests the two drugs have the effect of improving epithelial dysfunction and prevention of atherosclerosis.