艾塞那肽对2型糖尿病合并无症状高尿酸血症患者血尿酸水平的影响

发布时间：2018-03-30 20:25

本文选题：脂联素　切入点：艾塞那肽　出处：《重庆医学》2016年22期

【摘要】：目的观察艾塞那肽对2型糖尿病合并无症状高尿酸血症患者血尿酸(UA)水平的影响。方法选取2014年2月至2015年2月就诊于重庆市人民医院及第三军医大学西南医院门诊及住院部2型糖尿病合并高尿酸血症的患者58例,受试者分为治疗组30例、对照组28例。在原有的口服降糖药物治疗基础上,治疗组皮下注射艾塞那肽,初始剂量每次5μg,每天2次,1个月后根据临床效果调整为每次10μg,均为早、晚饭前60min内皮下注射;对照组皮下注射双时相门冬胰岛素30,起始剂量为0.2U/kg,每天2次,根据监测血糖水平调整胰岛素使用剂量,同时给予别嘌醇降尿酸。检测两组患者的脂联素(APN)、空腹血糖(FPG)、UA、胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)、体质量指数(BMI)水平并进行对比。结果治疗12周后,治疗组患者FPG、HbA1c及HOMA-IR较治疗前明显下降,APN水平较治疗前明显升高;治疗24周后,FPG、UA、HOMA-IR、BMI及HbA1c较治疗前明显下降,APN水平较治疗前明显升高。对照组治疗12周后,FPG、HbA1c较治疗前明显下降,但UA及HOMA-IR较治疗前无显著改变,APN水平较治疗前略有下降;治疗24周后,FPG、HbA1c、UA水平较治疗前明显下降,HOMA-IR及APN水平仍无明显变化,而BMI较治疗前略有增加。治疗24周后,治疗组APN较对照组明显升高,而BMI和HOMA-IR较对照组明显下降。结论艾塞那肽在降糖的同时,可有效降低UA水平,其降尿酸机制可能与其升高APN水平、增强胰岛素敏感性、减轻胰岛素抵抗、降低体质量有关。
[Abstract]:Objective to observe the effect of isenapeptide on serum uric acid (UAA) levels in patients with type 2 diabetes mellitus complicated with asymptomatic hyperuricemia. Methods from February 2014 to February 2015, they were admitted to Chongqing people's Hospital and Southwest Hospital of third military Medical University. 58 patients with type 2 diabetes complicated with hyperuricemia in outpatient and inpatient departments, The subjects were divided into the treatment group (n = 30) and the control group (n = 28). On the basis of the original oral hypoglycemic drug therapy, the treatment group was subcutaneously injected with 5 渭 g of isenapeptide at an initial dose of 5 渭 g twice a day, and one month later was adjusted to 10 渭 g each time according to the clinical effect. 60min was injected subcutaneously before supper, and the control group was subcutaneously injected with insulin 30, initial dose was 0.2 U / kg, twice a day. The dosage of insulin was adjusted according to blood glucose level. At the same time, allopurinol was given to reduce uric acid. The levels of adiponectin (APN), fasting blood glucose (FBG) and FPGU, insulin resistance index (HOMA-IRN), glycosylated hemoglobin (HbA1cN), body mass index (BMI) were measured and compared after 12 weeks of treatment. In the treatment group, the levels of HOMA-IR and HbA1c were significantly lower than those before treatment, and the levels of HOMA-IRN and HbA1c were significantly decreased after 24 weeks of treatment in the treatment group, and the levels of HbA1c in the control group after 12 weeks of treatment were significantly lower than those before treatment, and the levels of HbA1c in the control group were significantly decreased after 12 weeks of treatment, and the levels of HOMA-IRN and HbA1c in the treatment group were significantly lower than those before treatment. However, the levels of UA and HOMA-IR were not significantly changed compared with those before treatment, and the levels of HbA1cUA-UA were significantly decreased 24 weeks after treatment, but the levels of HOMA-IR and APN were not significantly changed, but BMI was slightly higher than that before treatment, and after 24 weeks of treatment, there was no significant change in the levels of HOMA-IR and APN, and after 24 weeks of treatment, there were no significant changes in the levels of HOMA-IR and APN. APN in the treatment group was significantly higher than that in the control group, while BMI and HOMA-IR in the treatment group were significantly lower than those in the control group. Conclusion Isenopeptide can effectively reduce UA level while lowering glucose, and its mechanism of decreasing uric acid may be similar to the increase of APN level and insulin sensitivity in the treatment group. It is related to reducing insulin resistance and reducing body mass.
【作者单位】：重庆市人民医院内分泌肾内科;第三军医大学西南医院内分泌科;
【分类号】：R587.1;R589.7

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