【摘要】目的  观察胰岛素促泌剂及阿卡波糖对血浆胰升血糖素样肽-1（GLP-1）、胰升血糖素（GC）的影响。  方法  选取新诊断T2DM患者127例，随机分为格列本脲（GG）组34例、瑞格列奈（RG）组32例、阿卡波糖（AG）组31例及西格列汀（SG）组30例。治疗12周，观察各组血糖、HbA₁c、GLP-1及GC的变化。  结果  各组治疗后FPG、2 hPG、HbA₁c均降低，GG组和RG组ΔHbA₁c高于AG组和SG组（P＜0.05）；AG组和SG组治疗后FGLP-1、2 hGLP-1升高，FGC、2 hGC降低（P＜0.05）；GG组和RG组治疗后空腹GLP-1(FGLP-1)、2 hGLP-1、空腹GC(FGC)及2 hGC与治疗前比较，差异无统计学意义（P＞0.05）；SG组ΔFGLP-1、2 hGLP-1及ΔFGC均高于AG组（P＜0.05）。  结论  格列本脲和瑞格列奈降糖效果优于西格列汀和阿卡波糖。西格列汀与阿卡波糖均能升高血浆GLP-1，降低GC水平。格列本脲和瑞格列奈无调节GLP-1和GC的作用。

【关键词】糖尿病，2型；西格列汀；阿卡波糖；胰岛素促泌剂；胰升血糖素；胰升血糖素样肽-1

The efficacy and regulation of insulin secretagogues and Acarbose on glucagon-like peptide-1 in newly diagnosed type 2 diabetes FAN Shi-zhen， YANG Jun-peng， ZHANG Chun-ling， et al. Department of Endocrinology and Metabolism, Zhengzhou First People’s Hospital, Zhengzhou 450004, China

Corresponding author: ZHAO Zhi-gang, E-mail:  zhaozhigang1957@126.com

【Abstract】Objectives  To investigate the influence of insulin secretagogues agent and acarbose on plasma glucagon-like peptide -1 (GLP-1) and glucagon (GC) when used for monotherapy in newly diagnosed type 2 diabetes (T2DM).  Methods  A total of 127 newly diagnosed T2DM patients were recruited and then randomly divided into four groups: Glibenclamide group（GG, n=34）, Repaglinide group（RG, n=32）,Acarbose group（AG, n=31）, Sitagliptin（SG, n=30）. The changes of glucose, HbA₁c, GLP-1 and GC levels among different groups were compared after 12 weeks treatment.  Results  After the treatment, the levels of FPG, 2 hPG and HbA₁c were significantly reduced in each group. Compared with AG group and SG group, the decrease of HbA₁c in GG group and RG group were statistically significant (all P＜0.05). The increase of FGLP-1 and 2 hGLP-1 and the decrease of FGC and 2 hGC were significant after treatment in AG group and SG group (all P＜0.05). The levels of FGLP-1, 2 hGLP-1, FGC and 2 hGC had no significant differences after treatment in GG group and RG group (all P＞0.05). Compared with SG group, the increase of FGLP-1 2 hGLP-1 and the decrease of FGC in AG group were statistically significant (all P＜0.05).  Conclusions  The hypoglycemic effect of Glibenclamide and Repaglinide are better than that of Sitagliptin and Acarbose. Sitagliptin and Acarbose could increase the level of plasma GLP-1 and decrease the level of GC; Glibenclamide and Repaglinide do not have the effect of regulating GLP-1 and GC.

【Key words】 Diabetes mellitus，type 2;Sitagliptin; Acarbose;Insulin secretagogues; Glucagon (GC); Glucagon-like peptide -1 (GLP-1)