中华糖尿病杂志
中華糖尿病雜誌
중화당뇨병잡지
CHINES JOURNAL OF DLABETES MELLITUS
2013年
8期
481-485
,共5页
蒋建家%牟伦盼%林振忠%孙炳庆%苏劲波%吴玉英%庄玉君%明德松
蔣建傢%牟倫盼%林振忠%孫炳慶%囌勁波%吳玉英%莊玉君%明德鬆
장건가%모륜반%림진충%손병경%소경파%오옥영%장옥군%명덕송
艾塞那肽%肥胖%糖调节受损%高胰岛素血症
艾塞那肽%肥胖%糖調節受損%高胰島素血癥
애새나태%비반%당조절수손%고이도소혈증
Exenatide%Obesity%Impaired glucose regulation%Hyperinsulinism
目的 探讨艾塞那肽对糖调节受损(IGR)肥胖者血胰岛素及血糖的影响.方法 选取2011年5月至2012年11月在福建医科大学附属泉州第一医院就诊的75例糖调节受损(IGR)肥胖者为研究对象,其中62例受试者符合入选条件,按基线胰岛素水平分为高胰岛素血症(HIns,32例)与非高胰岛素血症(NHIns,30例)2组,HIns以空腹胰岛素≥15 mU/L和(或)口服葡萄糖耐量试验(OGTT)2 h胰岛素≥80 mU/L作为切点.测定基线及应用艾塞那肽5d及14 d时的空腹与0GTT2h血浆血糖、胰岛素、C肽、体重等指标.以稳态模型评估的胰岛素抵抗指数(HOMA-IR)及Gutt胰岛素敏感指数评估胰岛素抵抗及敏感性.同一组治疗前后比较采用配对t检验,组间均数比较采用单因素方差分析,率的比较采用x2检验.结果 两组的空腹及OGTT 2 h血糖在用药5d时较基线下降(t =4.42、9.78、4.00、8.66,均P＜0.05),HIns组空腹胰岛素在用药5d时较基线下降(t=2.07,P ＜0.05),OGTT 2 h胰岛素在用药5d较基线时下降,用药14 d较5d时进一步下降(F =24.17,P＜0.05).HIns组HOMA-IR在用药5d时较基线下降(t=3.27,P＜0.05).NHIns组HOMA-IR在用药5d及14 d时较基线均无下降(均P＞0.05),HIns组Gutt胰岛素敏感指数在用药5d时较基线升高(t=-9.84,P＜0.05),14 d时较5d时进一步升高(F=55.96,P＜0.05).NHIns组Gutt胰岛素敏感指数在用药5d时较基线升高(t=-4.27,P＜0.05).HIns组与NHIns组体重在5d时较基线无下降,14 d时均较5d时明显下降(t=14.13、12.00,均P＜0.05).结论 IGR肥胖人群短期应用艾塞那肽即可获益调节血糖、改善胰岛素抵抗、控制体重.
目的 探討艾塞那肽對糖調節受損(IGR)肥胖者血胰島素及血糖的影響.方法 選取2011年5月至2012年11月在福建醫科大學附屬泉州第一醫院就診的75例糖調節受損(IGR)肥胖者為研究對象,其中62例受試者符閤入選條件,按基線胰島素水平分為高胰島素血癥(HIns,32例)與非高胰島素血癥(NHIns,30例)2組,HIns以空腹胰島素≥15 mU/L和(或)口服葡萄糖耐量試驗(OGTT)2 h胰島素≥80 mU/L作為切點.測定基線及應用艾塞那肽5d及14 d時的空腹與0GTT2h血漿血糖、胰島素、C肽、體重等指標.以穩態模型評估的胰島素牴抗指數(HOMA-IR)及Gutt胰島素敏感指數評估胰島素牴抗及敏感性.同一組治療前後比較採用配對t檢驗,組間均數比較採用單因素方差分析,率的比較採用x2檢驗.結果 兩組的空腹及OGTT 2 h血糖在用藥5d時較基線下降(t =4.42、9.78、4.00、8.66,均P＜0.05),HIns組空腹胰島素在用藥5d時較基線下降(t=2.07,P ＜0.05),OGTT 2 h胰島素在用藥5d較基線時下降,用藥14 d較5d時進一步下降(F =24.17,P＜0.05).HIns組HOMA-IR在用藥5d時較基線下降(t=3.27,P＜0.05).NHIns組HOMA-IR在用藥5d及14 d時較基線均無下降(均P＞0.05),HIns組Gutt胰島素敏感指數在用藥5d時較基線升高(t=-9.84,P＜0.05),14 d時較5d時進一步升高(F=55.96,P＜0.05).NHIns組Gutt胰島素敏感指數在用藥5d時較基線升高(t=-4.27,P＜0.05).HIns組與NHIns組體重在5d時較基線無下降,14 d時均較5d時明顯下降(t=14.13、12.00,均P＜0.05).結論 IGR肥胖人群短期應用艾塞那肽即可穫益調節血糖、改善胰島素牴抗、控製體重.
목적 탐토애새나태대당조절수손(IGR)비반자혈이도소급혈당적영향.방법 선취2011년5월지2012년11월재복건의과대학부속천주제일의원취진적75례당조절수손(IGR)비반자위연구대상,기중62례수시자부합입선조건,안기선이도소수평분위고이도소혈증(HIns,32례)여비고이도소혈증(NHIns,30례)2조,HIns이공복이도소≥15 mU/L화(혹)구복포도당내량시험(OGTT)2 h이도소≥80 mU/L작위절점.측정기선급응용애새나태5d급14 d시적공복여0GTT2h혈장혈당、이도소、C태、체중등지표.이은태모형평고적이도소저항지수(HOMA-IR)급Gutt이도소민감지수평고이도소저항급민감성.동일조치료전후비교채용배대t검험,조간균수비교채용단인소방차분석,솔적비교채용x2검험.결과 량조적공복급OGTT 2 h혈당재용약5d시교기선하강(t =4.42、9.78、4.00、8.66,균P＜0.05),HIns조공복이도소재용약5d시교기선하강(t=2.07,P ＜0.05),OGTT 2 h이도소재용약5d교기선시하강,용약14 d교5d시진일보하강(F =24.17,P＜0.05).HIns조HOMA-IR재용약5d시교기선하강(t=3.27,P＜0.05).NHIns조HOMA-IR재용약5d급14 d시교기선균무하강(균P＞0.05),HIns조Gutt이도소민감지수재용약5d시교기선승고(t=-9.84,P＜0.05),14 d시교5d시진일보승고(F=55.96,P＜0.05).NHIns조Gutt이도소민감지수재용약5d시교기선승고(t=-4.27,P＜0.05).HIns조여NHIns조체중재5d시교기선무하강,14 d시균교5d시명현하강(t=14.13、12.00,균P＜0.05).결론 IGR비반인군단기응용애새나태즉가획익조절혈당、개선이도소저항、공제체중.
Objective To investigate the effect of exenatide on serum insulin and plasma glucose in obese subjects with impaired glucose regulation(IGR).Methods A total of 75 obese subjects with IGR were enrolled from May 2011 to November 2012 in Quanzhou First Hospital Affiliated Fujian Medical University.A total of 62 eligible subjects were divided into the hyperinsulinemia group (HIns,fasting serum insulin ≥15 mU/L and(or)2-hour serum insulin ≥80 mU/L post glucose load,n =32) and the nonhyperinsulinemia group (NHIns,n =30) by the serum insulin level.Fasting and 2h plasma glucose in OGTT,insulin,C-peptide and body weight were measured at the baseline,D5 and D14 of exenatide treatment.Insulin resistance was evaluated by the dhomeostasis model assessment (HOMA-IR) and the gutt insulin sensitivity index.Paired t test was used to test within group change.One-way ANOVA was applied to compare differences of continuous variables between subgroups.Rates were compared by using the x2 test.Results Compared with the baseline,fasting and 2 h glucose significantly improved at D5 in the two groups,but without further decrease at D14 in the two groups (t =4.42,9.78,4.00,8.66 with all P ＜0.05).Compared with the baseline,the fasting insulin significantly decreased at D5 in the HIns group(t =2.07,P ＜0.05).The 2 h insulin level significantly decreased at D5 with further reduction at D14 in the HIns group(F =24.17,P ＜0.05).No significant decrease was observed with the fasting and 2 h insulin in the NHIns group at D5 and D14.HOMA-IR significantly decreased at D5 in the HIns groups(t =3.27,P ＜ 0.05),while showed no change at D5 and D14 in the NHIns group(all P ＞0.05).Gutt insulin sensitivity index increased at D5 in the HIns groups(t =-9.84,P ＜ 0.05) with further increase at D14 (F =55.96,P ＜ 0.05).Compared with the baseline,the Gutt insulin sensitivity index significantly increased at D5 in the NHIns group(t =-4.27,P ＜ 0.05).Body weight significantly decreased in the HIns group and the NHIns group at D14 (t =14.13,12.00,all P ＜ 0.05),while showed no change at D5 in both groups.None of the subjects withdrew because of adverse event including hypoglycemia.Conclusions Exenatide shortterm treatment in obese subjects with IGR can benefit glucose regulation,improve insulin resistance and control body weight.
