Reduction of oxidative stress and inflammation by blunting daily acute glucose fluctuations in patients with type 2 diabetes: role of dipeptidyl peptidase-IV inhibition.
Reduction of oxidative stress and inflammation by blunting daily acute glucose fluctuations in patients with type 2 diabetes: role of dipeptidyl peptidase-IV inhibition.
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DOI：
10.2337/dc12-0199
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发表时间：
2012-10
期刊：
影响因子：
16.2
通讯作者：
Paolisso G
中科院分区：
文献类型：
--
作者：
Rizzo MR;Barbieri M;Marfella R;Paolisso G
评价两种二肽基肽酶-IV（DPP-4）抑制剂西格列汀和维达利汀对2型糖尿病患者血糖波动平均幅度（法师）、氧化应激和全身炎症标志物的影响，已知这两种抑制剂对2型糖尿病患者的血糖波动平均幅度（MAGE）、氧化应激和全身炎症标志物具有不同疗效。在90例二甲双胍控制不佳的2型糖尿病患者中进行了一项前瞻性、随机、开放标签PROBE设计（设盲终点的平行组）研究。该研究将45例患者分配接受西格列汀（100 mg，每日一次;西格列汀组），45例患者接受维达鲁肽（50 mg，每日两次;维达鲁肽组），持续12周。法师，在48小时的连续皮下血糖监测，允许在基线和12周后，在所有患者的每日血糖波动的评估。在基线和12周后对所有患者进行氧化应激（硝基酪氨酸）和炎症标志物白细胞介素（IL）-6和IL-18的全身水平评估。基线时，两组之间的HbA 1c、空腹和餐后血糖、法师、炎症和氧化应激标志物相似。治疗12周后，维达格列汀组的法师评分低于西格列汀组（P < 0.01）。两组治疗后HbA 1c和餐后血糖变化相似（P = NS）。与西格列汀治疗相比，维达利治疗与硝基酪氨酸（P < 0.01）、IL-6（P < 0.05）和IL-18（P < 0.05）的更强降低相关。硝基酪氨酸和IL-6的变化与法师的变化显著相关，但与空腹血糖和HbA 1c无关。2型糖尿病患者中法师减少与氧化应激和全身炎症标志物的减少相关。这些效应在维达鲁肽组中大于西格列汀组。
Evaluate the effects of two dipeptidyl peptidase-IV (DPP-4) inhibitors, sitagliptin and vildagliptin, known to have different efficacy on mean amplitude of glycemic excursions (MAGE), on oxidative stress, and on systemic inflammatory markers in patients with type 2 diabetes. A prospective, randomized, open-label PROBE design (parallel group with a blinded end point) study was performed in 90 patients with type 2 diabetes inadequately controlled by metformin. The study assigned 45 patients to receive sitagliptin (100 mg once daily; sitagliptin group) and 45 patients to receive vildagliptin (50 mg twice daily; vildagliptin group) for 12 weeks. MAGE, evaluated during 48 h of continuous subcutaneous glucose monitoring, allowed an assessment of daily glucose fluctuations at baseline and after 12 weeks in all patients. Assessment of oxidative stress (nitrotyrosine) and systemic levels of inflammatory markers interleukin (IL)-6 and IL-18 was performed at baseline and after 12 weeks in all patients. HbA1c, fasting and postprandial glucose, MAGE, and inflammatory and oxidative stress markers were similar between the groups at baseline. After 12 weeks, MAGE (P < 0.01) was lower in the vildagliptin group than in the sitagliptin group. After treatment, HbA1c and postprandial glucose evidenced similar changes between the groups (P = NS). Vildagliptin treatment was associated with a stronger decrease in nitrotyrosine (P < 0.01), IL-6 (P < 0.05), and IL-18 (P < 0.05) than sitagliptin treatment. Nitrotyrosine and IL-6 changes significantly correlated with changes in MAGE but not in fasting glucose and HbA1c. MAGE reduction is associated with reduction of oxidative stress and markers of systemic inflammation in type 2 diabetic patients. These effects were greater in the vildagliptin group than in the sitagliptin group.
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