钠-葡萄糖共同转运体2抑制剂对2型糖尿病患者胰岛素敏感性及血清GPC-4的影响

Effects of sodium-glucose co-transporter 2 inhibitor on insulin sensitivity and serum GPC-4 in patients with type 2 diabetes mellitus

摘要:

目的： 探讨达格列净对2型糖尿病（type 2 diabetes mellitus，T2DM）患者胰岛素敏感性及血清磷脂酰肌醇蛋白聚糖-4（glypican-4，GPC-4）的影响。方法： 80例T2DM患者采用达格列净治疗12周，观察血糖、血脂、胰岛素敏感性及血清GPC-4水平的变化。以40例健康人作为正常对照。结果： T2DM组（5.05±0.98）的血清GPC-4水平低于正常对照组（6.42±0.51）（P=0.000），T2DM组经达格列净治疗后血糖（P=0.000）、HbA1c（P=0.000）和HOMA-IR（P=0.000）均降低，而GPC-4水平升高（P=0.000）。在T2DM组，HbA1c（β=-0.608，P=0.000）和1/HOMA-IR（β=-2.566，P=0.003）均是血清GPC-4的独立影响因子，但治疗前后GPC-4的升高程度与HbA1c降低程度正相关（r=0.397，P=0.002），与HOMA-IR的变化无关（r=-0.062，P=0.539）。结论： 达格列净具有降糖、改善胰岛素敏感性和升高循环GPC-4水平的作用，但其对血清GPC-4的影响可能与降糖有关，与其改善胰岛素敏感性的作用无关。

Abstract:

Objective: To investigate the effects of dapagliflozin on insulin sensitivity and serum glypican-4 (GPC-4) levels in patients with type 2 diabetes mellitus (T2DM). Methods: Eighty patients with T2DM were treated with dapagliflozin for 12 weeks, and the changes of blood glucose, blood lipid, insulin sensitivity and serum GPC-4 level were observed by an ELISA kit. Forty healthy subjects were taken as normal glucose control (NGT). Results: Serum GPC-4 levels were lower in T2DM (5.05±0.98) group than in NGT group (6.42±0.51) (P=0.000). Dapagliflozin increased serum GPC-4 levels in T2DM group (P=0.000), accompanied with decreases in blood glucose levels (P=0.000), HbA1c (P=0.000) and HOMA-IR (P=0.000). HbA1c (β=-0.608, P=0.000) and 1/HOMAIR (β=-2.566, P=0.003) were independent influencing factors of serum GPC-4 in T2DM patients. Elevation in serum GPC-4 levels were correlated positively with reduces in HbA1c (r=0.397, P=0.002), but no associations with decline in HOMA-IR (r=-0.062, P=0.539). Conclusion: Dapagliflozin therapy can decrease blood glucose levels, improve insulin sensitivity and increase GPC-4 levels for T2DM patients, and its effects on the serum GPC-4 level may be correlated with glucose control, but have no association with insulin sensitivity improvement.