摘要
目的探讨沙格列汀联合二甲双胍对老年2型糖尿病(T2DM)患者外周血炎性因子及单个核细胞(PBMCs)中NOD样受体热蛋白结构域相关蛋白-3(NLRP3)炎性体mRNA表达的影响。方法选取2016年1月-2019年1月南京鼓楼医院集团仪征医院收治的老年T2DM患者90例,按随机数字表法分为两组,每组45例。对照组采用二甲双胍治疗,观察组采用沙格列汀联合二甲双胍治疗。比较两组血糖达标率及不良反应,治疗前后检测外周血糖代谢指标、炎性因子[白介素-1β(IL-1β)、白介素-6(IL-6)、白介素-17A(IL-17A)、白介素-18(IL-18)、白介素-23(IL-23)]及PBMCs中NLRP3炎性体mRNA表达水平。结果观察组的血糖达标率高于对照组(P<0.05)。治疗后,观察组的体质量指数(BMI)、糖化血红蛋白(HbAlc)、空腹血糖(FPG)、餐后2 h血糖(2hPG)、胰岛素抵抗指数(HOMA-IR)均低于对照组,胰岛β细胞功能指数(HOMA-β)高于对照组(P<0.05)。治疗后,观察组的IL-1β、IL-6、IL-17A、IL-18及IL-23水平及PBMCs中NLRP3 mRNA、ASC mRNA及Caspase-1 mRNA表达量均低于对照组(P<0.05)。结论沙格列汀联合二甲双胍治疗老年T2DM能够改善糖代谢紊乱、胰岛素抵抗及胰岛β细胞功能,提高血糖控制效果,其机制可能与下调外周血促炎性因子及PBMCs中NLRP3炎性体mRNA表达水平有关。
Objective To investigate the influence of saxagliptin combined with metformin on peripheral blood inflammatory factors and NOD-like receptor pyrin domain containing 3(NLRP3)inflammasome mRNA expression of peripheral blood mononuclear cells(PBMCs)in elderly patients with type 2 diabetes mellitus(T2DM).Methods 90 elderly patients with T2DM admitted to our hospital from January 2016 to January 2019 were enrolled and randomly divided into two groups,with 45 cases in each group.The control group was treated with metformin,the observation group was treated with saxagliptin and metformin.The blood glucose compliance rate and adverse reactions were compared between the two groups.Peripheral blood glucose metabolism indicators,inflammatory factors[interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-17A(IL-17A),interleukin-18(IL-18),interleukin-23(IL-23)]and NLRP3 inflammasome mRNA expression in PBMCs were measured before and after treatment.Results The blood glucose compliance rate of the observation group was higher than that of the control group and the difference between the two groups was statistically significant(P<0.05).After treatment,the body mass index(BMI),hemoglobin Alc(HbA1c),fasting plasma glucose(FPG),postprandial 2h plasma glucose(2hPG)and insulin resistance index(HOMA-IR)were lower than those of the control group,and isletβ-cell function index(HOMA-β)was higher than that of the control group,the differences between the two groups were statistically significant(P<0.05).After treatment,the levels of IL-1β,IL-6,IL-17A,IL-18 and IL-23 and the expression of NLRP3 mRNA,ASC mRNA and Caspase-1 mRNA in PBMCs in the observation group were lower than those in the control group and the differences between the two groups were statistically significant(P<0.05).Conclusion Saxagliptin combined with metformin in the treatment of elderly T2DM can improve glucose metabolism disorder,insulin resistance and isletβ-cell function,and can improve the blood sugar control effect.The mechanism may be related to down-regulati
作者
陈仲钰
俞晓芳
解正林
Chen Zhongyu;Yu Xiaofang;Xie zhenglin(Department of Endocrinology,Yizheng Hospital of Nanjing Gulou Hospital Group,Yizheng 211400,China)
出处
《湖北民族大学学报（医学版）》
2020年第2期29-33,共5页
Journal of Hubei Minzu University(Medical Edition)
