吡格列酮对2型糖尿病患者尿转化生长因子β1排泄的影响

·糖尿病性肾脏疾病·

胡圆圆 赵俐丽 郑茂 陈燕 叶山东

作者单位：230001合肥，安徽医科大学附属安徽省立医院内分泌科

【摘要】 目的 观察吡格列酮对2型糖尿病(T2DM)患者尿转化生长因子β1(TGF-β1)排泄的影响，探讨其肾脏保护作用及机制。 方法 98例血糖控制欠佳的T2DM 患者随机分为联合吡格列酮(DP组)和磺酰脲类(DS组)，治疗12周。检测治疗前后FPG、HbA1c、尿白蛋白(UAlb)、肌酐(Cr)和TGF-β1水平。 结果 (1)治疗后，两组患者FPG、HbA1c和尿TGF-β1/Cr 比值均显著降低，差异均有统计学意义。DP组UAlb/Cr比值(UAER)显著降低(P<0.01);DS组UAER 轻度降低，差异无统计学意义。(2)治疗后两组间FPG和HbA1c比较，差异无统计学意义。与DS组治疗后比较，DP组治疗后UAER和TGF-β1/Cr值显著降低(P<0.05)。(3)尿TGF-β1/Cr值与UAER显著正相关(r=0.367，P<0.01)。 结论 吡格列酮可减少T2DM患者UAlb和TGF-β1排泄，其肾脏保护作用可能与其抑制体内TGF-β1表达和排泄有关。

doi:10.3969/j.issn.1006-6187.2011.06.007

Effects of pioglitazone on urinary transforming growth factor-β1 excretion in type 2 diabetics

HU Yuan-yuan，ZHAO Li-li，ZHENG Mao，et al.Department of Endocrinology，Anhui Provincial Hospital Affiliated to Anhui Medical University，Hefei 230001，China

【Abstract】 Objective To observe the effects of pioglitazone on urinary transforming growth factor-β1 (TGF-β1) excretion in type 2 diabetics and explore the renoprotective mechanism. Methods 98

uncontrolled diabetic patients treated with metformin and/or acarbose were randomly assigned to combined pioglitazone(DP group)or sulfonylurea(DS group)treatment for twelve weeks. Results In post-treatment versus pre-treatment，fasting blood glucose(FBG)，HbA1c and urinary TGF-β1/creatinine ratio(TGF-β1/Cr)were all obviously decreased in both DP and DS groups (all P<0.05).After 12 weeks’ treatment, the urinary albumin/creatinine ratio (UAER)obviously decreased in DP group (P<0.01)，while slightly decreased in DS group(P>0.05).After treatment，FBG and HbA1c had no marked difference between two groups (P>0.05)，while UAER and urinary TGFβ1/Cr were significantly lower in DP group than in DS group (P<0.05).Urinary TGF-β1/Cr had positive correlation with the UAER (r=0.367，P<0.01). Conclusion Pioglitazone can decrease urinary albumin and TGFβ1 excretion in type 2 diabetics，and the renoprotection may partly be due to its effects on suppressing the expression and excretion of TGFβ1 in vivo.

【Key words】Diabetic kidney disease;Transforming growth factor β1;Pioglitazone