摘要
目的观察厄贝沙坦对2型糖尿病（type 2 diabetes mellitus，T2DM）合并高血压患者胰岛素抵抗（insulin resistance，IR）及胰岛B细胞功能的影响。方法将94例初发T2DM合并高血压患者随机分为两组（n=47）：厄贝沙坦组、苯磺酸氨氯地平组，分别给予厄贝沙坦和苯磺酸氨氯地平治疗12周。比较治疗前后两组患者体质量指数（body mass index，BMI）、腰围（waist circumference，WC）、血压（bloodpressure，BP）、空腹血糖（fasting blood glucose，FBG）、空腹胰岛素（fasting plasma insulin，FINS）、糖化血红蛋白（glycosylated hemoglobin，HbAlC）、甘油三酯（triglyeride，TG）、总胆固醇（totalcholesterol，TC）、低密度脂蛋白胆固醇（low—density lipoprotein cholesterol，LDL—C），并采用稳态模式评估法计算胰岛素抵抗指数（HOMA—HOMA-insulin resistance index，HOMA，IR）、胰岛素分泌指数（HOMA—pcellSecretionindex，HOMA—p）及治疗前后的变化。结果治疗12周后，两组患者治疗后的BP、FBG、HbAlC均较治疗前降低（均P〈0．05），两组患者治疗后的胰岛素分泌指数均较治疗前升高（均P〈0．05），两组治疗前后WC、BMI、TG、TC、LDL—C、HDL．C差异均无统计学意义（均P〉0．05）。厄贝沙坦组治疗后胰岛素抵抗指数较治疗前下降[3．79（2．51～4．99）掷4．58（3．38—5．94），P〈0．05]，氨氯地平组治疗前后胰岛素抵抗指数差异无统计学意义[3．90（2．52—5．26）1）83．90（2．52～5．26），P〉0．05]。结论厄贝沙坦在降低血压的同时，可能改善T2DM患者的胰岛素抵抗。
Objective To determine the effects of irbesartan on insulin resistance and islet β-cell function in the patients with type2 diabetes mellitus （T2DM） complicated with hypertension. Methods Ninety-four patients with newly diagnosed T2DM complicated with hypertension admitted in our hospital from November 2011 to March 2012 were prospectively enrolled in this study. They were randomly assigned into 2 groups and received either irbesartan （150 to 300 mg/d） or amlodipine （5 to 10 mg/d） treatment for 12 weeks. The clinical characteristics, such as body mass index （BMI）, waist circumference （WC）, blood pressure （BP）, fasting plasma glucose （FBG） and insulin （FINS）, and serum levels of glycosylated hemoglobin （ HbA1 c）, triglyeride （TG）, total cholesterol （TC） and low-density lipoprotein cholesterol （LDL-c） were collected before and after treatment. Homeostasis model assessment （HOMA） was used to calculate the insulin resistance index （ HOMA-IR = fasting serum insulin fasting serum glucose/22.5 ） and insulin secretion index （ HOMA-β = fasting serum insulin x 20/fasting glucose-3.5 ）. Results After 12 week treatment, the BP, FBG and HbAlc were decreased, while the insulin secretion index was significantly increased in both groups （P 〈 0.05 ）. There was no significant difference in the WC, BMI, TC, LDL-c and HDL-c in the 2 Conclusion While effectively controlling the blood pressure, irbesartan can improve the insulin resistance in T2DM patients.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2014年第15期1635-1638,共4页
Journal of Third Military Medical University
关键词
厄贝沙坦
胰岛素抵抗
2型糖尿病
irbesartan
insulin resistance
type2 diabetes mellitus
