文章摘要
戴晓康,叶山东.二甲双胍对2型糖尿病患者尿TNF-α排泄的影响[J].南京医科大学学报,2016,(6):746~749
二甲双胍对2型糖尿病患者尿TNF-α排泄的影响
Effects of metformin treatment on urinary TNF-α excretion in type 2 diabetic patients
投稿时间:2015-09-24  
DOI:10.7655/NYDXBNS20160621
中文关键词: 二甲双胍  2型糖尿病  糖尿病肾脏疾病  TNF-α  炎症因子  尿白蛋白
英文关键词: metformin  type 2 diabetes mellitus  diabetic kidney disease  TNF-α  inflammatory factor  urinary albumin
基金项目:安徽省自然科学基金(1508085SMH227);安徽高校省级自然科学研究项目(KJ2011A157)
作者单位
戴晓康 安徽医科大学附属省立医院内分泌科,安徽 合肥 230001 
叶山东 安徽医科大学附属省立医院内分泌科,安徽 合肥 230001 
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中文摘要:
      目的:观察二甲双胍(metformin,Met)对2型糖尿病(type 2 diabetes mellitus,T2DM)患者尿肿瘤坏死因子(tumor necrosis factor,TNF)-α排泄的影响,探讨其可能的肾脏保护作用?方法:121例T2DM患者(DM组)根据抗糖尿病治疗方案分为胰岛素(insulin,INS)组和磺脲类(sulfonylurea,SU)组,再根据是否联合Met各分2个亚组(INS-Ⅰ组,INS未联合Met,INS-Ⅱ,INS联合Met;SU-Ⅰ组,SU未联合Met,SU-Ⅱ组,SU联合Met),同期选择安徽医科大学附属省立医院体检中心24例健康体检人员作为正常对照组(NC组),比较DM组和NC组及DM各亚组间空腹血浆葡萄糖(fasting blood glucose,FBG)?OGTT试验2 h葡萄糖(postprandial blood glucose,PBG)?糖化血红蛋白A1c(glycated haemoglobinA1c,HbA1c)?病程?体重指数?血压?血肌酐?尿白蛋白?尿TNF-α排泄的变化?结果:①DM组FBG?PBG?HbA1c?尿TNF-α肌酐比(urinary TNF-α/creatinine ratio,UTCR)?尿白蛋白肌酐比(urinary albumin/creatinine ratio,UACR)水平较NC组明显升高;②与INS-Ⅰ组相比,INS-Ⅱ组UTCR和UACR明显降低,差异有统计学意义 (P < 0.05);与SU-Ⅰ组相比,SU-Ⅱ组UTCR和UACR明显降低(P < 0.05);③T2DM患者UTCR与UACR呈显著性正相关(r=0.73,P < 0.01)?结论:Met可减少T2DM患者尿TNF-α的排泄,该作用可能与其肾脏保护作用有关?
英文摘要:
      Objective:To observe the effects of metformin treatment on urinary TNF-α in type 2 diabetic patients and explore its possible reno-protective mechanisms. Methods:A total of 121 of type 2 patients (the DM group) were divided into the insulin group and the sulfonylurea group,they were divided to 2 subpoups according to whether or not they received metformin (the INS-Ⅰ group,insulin only;the INS-Ⅱ group,insulin+metformin;the SU-Ⅰ group,sulfonylurea only;the SU-Ⅱ group,sulfonylurea metformin). Meanwhile,24 healthy subjects were selected as the normal control group (the NC group) so that FPG,PBG,HbA1c,duration,BMI,serum creatinine,urinary albumin/creatinine ratio (UACR) and urinary TNF-α/creatinine ratio (UTCR) were determined respectively between the NC group and the DM group and changes in them excretion were determined in subgroups. Results:1. In the DM group,the levels in FBG,PBG,HbA1c,UTCR and UACR were significantly higher than those in the NC Group. 2. Compared with the INS-Ⅰ group,UTCR and UACR in the INS-Ⅱ group were significantly decreased(P < 0.05);while compared with the SU-Ⅰ group,UTCR and UACR in the SU-Ⅱ group were significantly decreased (P < 0.05). 3. UTCR had significant positive correlation with UACR in patients with T2DM (r=0.73,P < 0.01). Conclusion:Metformin can reduce excretion of urinary TNF-α in type 2 diabetic patients,which may be associated with its renal protection.
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