CAJ | 학술논문

目的探讨吡格列酮对2型糖尿病(T2DM)患者尿单核细胞趋化蛋白1(MCP-1)排泄的影响及意义.方法 90例T2DM患者随机分为吡格列酮干预组(DP组,44例)和磺酰脲类药物干预组(DS组,46例),观察12周,测定治疗前后两组的FBG、HbA1C水平及UA1b/Cr(UACR)和尿MCP-1/Cr比值(UMCR).结果 (1)基础时,两组指标差别无显著性;(2)治疗后两组FBG和HbA1c均明显降低(P<O.01),但两组间无显著性差别;两组UMCR均明显降低(P<0.01和0.05),DP组UACR明显降低(P<0.01),DS组UACR轻度降低(P>0.05);与DS组相比较,DP组UACR和UMCR显著降低(P<0.05);(4)DM组患者UMCR水平与HbA1c(r=0.652,P<0.01)和UACR(r=0.695,P<0.01)呈正相关.结论吡格列酮可能减轻肾组织局部增强的炎症反应,对糖尿病肾损伤提供保护作用.
목적 탐토필격렬동대2형당뇨병(T2DM)환자뇨단핵세포추화단백1(MCP-1)배설적영향급의의.방법 90례T2DM환자수궤분위필격렬동간예조(DP조,44례)화광선뇨류약물간예조(DS조,46례),관찰12주,측정치료전후량조적FBG、HbA1C수평급UA1b/Cr(UACR)화뇨MCP-1/Cr비치(UMCR).결과 (1)기출시,량조지표차별무현저성;(2)치료후량조FBG화HbA1c균명현강저(P<O.01),단량조간무현저성차별;량조UMCR균명현강저(P<0.01화0.05),DP조UACR명현강저(P<0.01),DS조UACR경도강저(P>0.05);여DS조상비교,DP조UACR화UMCR현저강저(P<0.05);(4)DM조환자UMCR수평여HbA1c(r=0.652,P<0.01)화UACR(r=0.695,P<0.01)정정상관.결론 필격렬동가능감경신조직국부증강적염증반응,대당뇨병신손상제공보호작용.
Objective To observe the effects of pioglitazone therapy on urinary monocyte chemoattractant protein-1 (MCP-1) excretion in type 2 diabetics and to probe its possible reno-protective mechanisms. Methods 90 type 2 diabetic patients with fasting blood glucose (FBG) 7.0~13.0mmol/L and hemoglobin A1C (HbA1c) ≥7.0% were assigned randomly into group DP (pioglitazone add-on) and group DS (sulfonylureas add-on).The levels of FBG,HbA1c, urinary albumin to creatinine ratio (UACR) and urinary monocyte chemoattractant protein-1 to creatinine ratio (UMCR) were determined at baseline and at 12th week after treatments. Results (1) At baseline, there were no significant differences in FBG, HbA1c、UACR and UMCR between the two groups;(2) After 12 weeks of treatment, the FBG and HbA1c levels decreased obviously in both groups (P<0.01), however, there was no significant diffirence in the FBG and HbA1c levels between the two therapy groups.(3) Meanwhile, the UMCR was significantly delined in two groups (group DS, P<0.05 and group DP, P<0.01).UACR was obviousely decreased in group DP (P<0.01) and slightly decreased in group DS (P>0.05).Compared to group DS, the UACR and UMCR were lowered significantly in group DP at the 12th week, (P<0.05).(4) The UMCR levels in DM group were positive associated with HbA1c (r＝0.652, P<0.01)and UACR (r＝0.695, P<0.01). Conclusion sPioglitazone can protect against kidney injury through lessening the increased inflammatory reaction in local kidney of type 2 diabetics.