摘要
目的 探讨达格列净联合胰岛素对超重/肥胖2型糖尿病的疗效及外周血来源外泌体miR-21表达的影响。方法 以2021年9月-2022年10月衡水市人民医院内分泌科收治的64例超重/肥胖2型糖尿病患者为研究对象,随机分为两组,对照组患者采用胰岛素治疗,观察组患者采用达格列净联合胰岛素治疗。两组患者治疗4周后记录患者胰岛素的使用剂量;采用血糖测定仪测定患者空腹血糖(Fasting blood glucose, FPG)、餐后2 h血糖(2-hour Postprandial blood glucose, 2 h PBG)水平;采用化学发光法检测空腹胰岛素水平(Fasting insulin, FINS),根据FINS水平和FPG水平计算胰岛素分泌指数(Homeostatic model assessment of β-cell function, HOMA-β)、胰岛素抵抗指数(Homeostatic model assessment of insulin resistance, HOMA-IR)、以及胰岛素敏感指数(Insulin sensitivity index, ISI)。记录两组患者治疗期间不良反应发生情况。qRT-PCR检测血清外泌体中miR-21的水平,采用Pearson相关系数分析miR-21水平与糖代谢指标的相关性。结果 与对照组比较,观察组患者治疗后1周、2周、3周、4周胰岛素的使用剂量均降低(P均<0.05)。与本组治疗前比较,治疗4周后两组患者FPG、2 h PBG、HOMA-IR水平均降低,HOMA-β、ISI水平升高(P均<0.05)。与对照组治疗4周后比较,观察组治疗4周后FPG、2 h PBG、HOMA-IR水平均降低,HOMA-β、ISI水平均增高(P均<0.05)。与本组治疗前比较,治疗4周后两组患者外泌体miR-21水平均下降(P<0.05)。与对照组治疗4周后比较,观察组患者经过治疗4周后外泌体miR-21水平下降(P<0.05)。Pearson相关系数分析结果显示外泌体miR-21水平与FPG、2 h PBG、HOMA-IR呈正相关,与HOMA-β、ISI呈负相关(P均<0.05)。两组患者治疗期间副作用发生率差异无统计学意义(P>0.05)。结论 达格列净联合胰岛素治疗超重/肥胖2型糖尿病疗效优于单独使用胰岛素治疗,本方法可控制血糖、降低外泌体miR-21水平,
Objective To investigate the effects of daglipzin combined with insulin on overweight/obese patients with type 2 diabetes mellitus and the influence of peripheral blood derived exosome miR-21 expression.Methods 64 overweight/obese patients with type 2 diabetes admitted to the hospital from Septem-ber 2021 to October 2022 were randomly divided into 2 groups.The patients in control group were treated with insulin,and the patients in observation group were treated with dagaglizin combined with insulin.The dosage of insulin was recorded after 4 weeks of the treatment in both groups.Fasting blood glucose(FPG)and 2-hour postprandial blood glucose(2 h PBG)were measured by fasting blood glucose analyzer.Fasting insulin(FINS)levels were detected by chemiluminescence method.Homeostatic model assess-ment ofβ-cell function(HOMA-β),homeostatic model assessment of insulin resistance(HOMA-IR)and insulin sensitivity index(ISI)was calculated individually according to FINS level and FPG level.Adverse reactions during the treatment were recorded in both groups.The level of miR-21 in serum exosomes was detected by qRT-PCR,and the correlation between the level of miR-21 and glucose metabolism indexes were analyzed by Pearson correlation coefficient.Results Compared with control group,the dosage of in-sulin used in observation group was decreased 1 week,2 weeks,3 weeks and 4 weeks after the treatment,and the difference was statistically significant(P<0.05).After 4 weeks of the treatment,FPG,2 h PBG and HOMA-IR levels were decreased,while HOMA-βand ISI levels were increased in the two groups,and the differences were statistically significant(P<0.05).Compared with the control group after 4 weeks of treatment,FPG,2 h PBG and HOMA-IR levels in the observation group after 4 weeks of the treatment were decreased,while HOMA-βand ISI levels were increased(P<0.05).Compared with the control group before the treatment,exosome miR-21 levels in both groups were decreased after 4 weeks of the treatment(P<0.05).Compared with the control group af
作者
孙殿静
李晓龙
张艳
SUN Dianjing;LI Xiaolong;ZHANG Yan(Department of Endocrinology,Hengshui People's Hospital,Hengshui Hebei 053000,China)
出处
《新疆医科大学学报》
CAS
2023年第10期1333-1337,共5页
Journal of Xinjiang Medical University
基金
河北省医学科学研究课题计划项目(20200411)。
