【摘要】 目的 探讨吡格列酮和二甲双胍治疗对肥胖T2DM患者血清APN的不同影响。 方法 将48例初诊肥胖T2DM患者随机分两组，分别给予二甲双胍(M组)和二甲双胍联合吡格列酮(MP组)治疗12周;于治疗前后测定受试者空腹血清APN、FPG、HbA1c、血脂、FIns，计算BMI、胰岛素抵抗指数(HOMA-IR)。 结果 与治疗前相比，MP组APN水平明显升高(P=0.0005)，MP组FPG、HbA1c、HOMA-IR、BMI、FIns明显降低(P<0.05);与治疗前相比，M组APN水平没有明显改变(P=0.487)，BMI、FPG、HbA1c、HOMA-IR、FIns、LDL明显降低(P<0.05)。 结论 吡格列酮治疗能有效增加肥胖T2DM患者血清脂联素水平。

　　【关键词】糖尿病;脂联素;吡格列酮;二甲双胍

　　Influence of pioglitazone and metformin on adiponectin in patients with diabetes mellitus type 2

　　DENG Chen-xin, GAO Ling, Yang Ying. Department of Endocrinology, Xiangyang Central Hospital, Xiangfan University, Xiangyang 441021, China

　　Corresponding author: GAO Ling, E-mail:doctorxiaohong@yahoo.com.cn

　　【Abstract】 Objective To observe the influence of pioglitazone and metformin on adiponectin and insulin resistance in obese patients with diabetes mellitus type 2. Methods Forty-eight newly diagnosed obese T2DM patients were randomized into two groups and treated with metformin (M group) or pioglitazone combined with metformin (MP group) for 12 weeks respectively. The serum adiponectin (APN), fasting blood sugar (FPG), HbA1c, blood fat, and fasting insulin (FIns) were assessed before and after treatment. The height and weight of patients were measured to calculate body mass index (BMI) and insulin resistance index (HOMA-IR). Results Compared with before treatment, the level of APN increased significantly (P=0.005), and the levels of FPG, HbA1c, HOMA-IR, BMI, and FIns decreased significantly (P<0.05) in the MP group after treatment; the level of APN was not significantly changed (P=0.487), and the levels of BMI, FPG, HbA1c, HOMA-IR, FIns, and LDL decreased significantly (P<0.05) in the M group after treatment. Conclusion Pioglitazone may increase the level of adiponectin in the obese T2DM patients.

　　【Key words】 Diabetes mellitus; Adiponectin; Pioglitazone; Metformin