·糖尿病与肥胖、脂质代谢异常·

　　格列吡嗪和/或二甲双胍对2型糖尿病患者血清脂联素水平的影响

　　潘斌斌 马建华 袁璐 郭琳 孙睿 王敏 苏晓飞

　　【摘要】 目的 比较二甲双胍格列吡嗪复方制剂及单药二甲双胍或格列吡嗪控制T2DM患者血糖达标前后脂联素水平的变化 方法 将63例T2DM患者分为三组：A组22例，服用二甲双胍格列吡嗪复合制剂;B组18例，服用二甲双胍片;C组23例，服用格列吡嗪片;疗程为12周。比较治疗前后空腹及餐后血糖、血清胰岛素、HbA1c、HOMA-IR、脂联素等相关指标。 结果 治疗前后，A、B组脂联素显著升高(P<0.01)，C组脂联素水平下降，但差异无统计学意义;三组间脂联素变化值比较示A组显著高于B、C组(P<0.05或P<0.01)，B组显著,高于C组(P<0.01);相关性分析示脂联素变化值与HOMA-IR、BMI呈负相关(r=-0.342,P<0.01;r=-0.336,P<0.01)。 结论 二甲双胍可能通过改善IR、改善体重进而降低BMI等途径来升高脂联素;二甲双胍格列吡嗪复方制剂改善脂联素作用可能是二甲双胍和格列吡嗪的协同作用，故而能更显著升高血清脂联素水平。

　　【关键词】 二甲双胍格列吡嗪复合制剂;脂联素;糖尿病，2型;HOMA-IR

Influence of glipizide and/ormetfomin on adiponectin in T2DM Patients PAN Bin-bin, MA Jian-hua, YUAN Lu, et al. Department of Endocrinology , Nanjing the First Hospital Affiliated to Nanjing Medical University, Nanjing 210012, China

Corresponding author: SU Xiao-fei, Email: suxiaofeifei@126.com

　　【Abstract】 Objective To detect the changes in plasma level of adiponectin in T2DM patients when their blood glucose was controlled with metformin or glipizide or the compound of the two. Methods Sixty-three T2DM patients were divided into 3 groups: Group A, 22 patients, treated with the compound metformin and glipizide; Group B, 18 patients, treated with metformin; and Group C, 23 patients, treated with glipizide, for 12 weeks. Comparison was made to observe the changes in the levels of fasting and postprandial glucose, insulin, HbA1c, HOMA-IR, HOMA-β, and serum adiponectin among the 3 groups after treatment. Results The patients in Group A and B got a significant increase in serum adiponectin (P<0.01), the patients in group C got a decrease in serum adiponectin, although the difference was not significant. The change level of adiponectin in group A was significantly higher than in group B and C (P<0.05 or P<0.01), and the change level of group B was higher than of group C (P<0.01). The correlation analysis showed that the change level of adiponectin was negatively correlated with BMI and HOMA-IR (r=-0.342, P<0.01; r=-0.336, P<0.01). Conclusion Metformin may increase adiponectin through improving HOMA-IR and decreasing BMI. The improved effects of compound glipizide and metformin on adiponectin may be synergistic actions of glipizide and metformin.

　　【Key words】 Compound glipizide and metformin; Adponectin; Diabetes mellitus, type 2; Homeostalic model assessment insulin resistance (HOMA-IR)