瑞格列奈及二甲双胍对糖尿病肾病患者血清转化生长因子-β1及糖脂代谢水平的影响

The effects of regorazine and metformin on serum levels of transforming growth factor-β1 and glucose and lipid metabolism in diabetic nephropathy patients

摘要:

目的 探讨瑞格列奈和二甲双胍对糖尿病肾病患者血清转化生长因子-β₁（TGF-β₁）及糖脂代谢水平的影响。方法 选取2021年1月—2024年5月在徐州市中心医院治疗的157例糖尿病肾病患者为研究对象。将患者随机分为瑞格列奈组（78例）和二甲双胍组（79例），治疗6周。观察两组患者治疗疗效、肾功能、肾纤维化指标、在治疗前后血清TGF-β₁水平及糖脂代谢指标的变化。记录两组患者不良反应发生情况。结果 瑞格列奈组的总有效率高于二甲双胍组（P <0.05）。瑞格列奈组治疗前后的血清肌酐、尿素氮、β2-微球蛋白、尿白蛋白肌酐比值和估算肾小球滤过率的差值高于二甲双胍组（P <0.05）。瑞格列奈组治疗前后的空腹血糖、糖化血红蛋白、总胆固醇、甘油三酯、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇的差值高于二甲双胍组（P <0.05）。瑞格列奈组治疗前后的Ⅳ型胶原、TGF-β₁和组织金属蛋白酶抑制剂1的差值高于二甲双胍组（P <0.05）。两组不良反应发生率比较，差异无统计学意义（P >0.05）。结论 瑞格列奈和二甲双胍均能有效降低糖尿病肾病患者血清TGF-β₁水平及改善糖脂代谢，其中瑞格列奈在调节血清TGF-β₁水平及改善糖脂代谢方面的效果优于二甲双胍。对于糖尿病肾病患者，尤其是需要同时控制血糖和血脂的患者，瑞格列奈可能是一个更合适的选择。

Abstract:

Objective To explore the effects of regorazine and metformin on serum transforming growth factor-β₁ (TGF-β₁) levels and glucose-lipid metabolism in patients with diabetic nephropathy.Methods We selected 157 diabetic nephropathy patients at our hospital between January 2021 and May 2024. These patients were randomly assigned to either the regorazine treatment group (78 patients) or the metformin treatment group (79 patients) for a 6-week treatment period. We evaluated treatment efficacy, changes in renal function, renal fibrosis markers, serum TGF-β₁ levels, and alterations in glucose and lipid metabolism indicators. Adverse reactions were also recorded.Results he total effective rate in the regorazine group was significantly higher than in the metformin group (P <0.05). The differences in serum creatinine, blood urea nitrogen, β2-microglobulin, urine albumin-to-creatinine ratio, and estimated glomerular filtration rate before and after treatment were significantly higher in the regorazine group compared to the metformin group (P <0.05). The differences in fasting blood glucose, glycated hemoglobin, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol before and after treatment were also significantly higher in the regorazine group than in the metformin group (P <0.05). Additionally, the differences in type Ⅳ collagen, TGF-β₁, and tissue inhibitor of metalloproteinase-1 before and after treatment were significantly greater in the regorazine group compared to the metformin group (P <0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P >0.05).Conclusion Both regorazine and metformin effectively decrease serum TGF-β₁ levels and enhance glucose and lipid metabolism in diabetic nephropathy patients. However, regorazine is superior in managing TGF-β₁ levels and improving metabolic parameters. Thus, regorazine may be a more appropriate therapeutic option for diabetic nephropathy patients requiring simultaneous control of blood glucose and lipids.