Potential Role of Salicylates in Type 2 Diabetes
Potential Role of Salicylates in Type 2 Diabetes
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DOI：
10.1345/aph.1m483
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发表时间：
2010-07-01
影响因子：
2.9
通讯作者：
Kim, Katelynn S.
中科院分区：
文献类型：
--
作者：
Rumore, Martha M.;Kim, Katelynn S.
目的：回顾支持使用水杨酸盐控制 2 型糖尿病患者血糖水平的证据基础，并全面回顾描述水杨酸盐（特别是水杨酸盐）在 2 型糖尿病预防和治疗中控制血糖的潜在作用的现有信息。 数据来源：使用 MEDLINE（1966 年 3 月，2010 年）、PubMed 和 Google Scholar 进行文献检索，使用搜索词水杨酸盐、水杨酸、阿司匹林、双水杨酸、乙酰水杨酸、胰岛素、葡萄糖、血糖控制、糖尿病、高血糖和核因子。对已确定文章的参考书目进行了额外引用的审查。 研究选择和数据提取：对水杨酸盐用于与胰岛素抵抗或糖尿病预防相关的血糖控制的药理学、功效和安全性的所有相关英文信息进行了审查。临床前数据、临床试验和病例报告均已确定、评估并纳入本次系统评价中。 数据综合：炎症治疗可能是预防和治疗 2 型糖尿病的潜在新策略，因为身体对胰岛素的作用具有抵抗力。之前和最近的研究揭示了炎症和肥胖之间可能存在的关系。多项研究发现，由于低度炎症而导致的免疫系统慢性激活与肥胖有关，而这反过来又会促进胰岛素抵抗和糖耐量受损的发展。一个多世纪前，水杨酸盐的施用就被证明可以降低糖尿病患者的血糖水平。许多体外和体内药理学研究已经证明水杨酸盐具有降血糖作用。多项临床研究和病例报告发现水杨酸盐，尤其是双水杨酸盐是治疗糖尿病的潜在药物，具有良好的安全性。尽管这些研究存在固有的局限性，例如患者数量少和持续时间短，但绝大多数研究都显示出显着的降血糖作用。美国国家糖尿病、消化和肾脏疾病研究所赞助的一项大型随机试验“用双水杨酸盐治疗 2 型糖尿病 (TINSAL-T2D)”试验最近得出结论，双水杨酸盐可降低血红蛋白 A(1c) 水平并改善 2 型糖尿病患者的血糖控制。结论：水杨酸盐，尤其是双水杨酸盐，通过降低血糖水平，似乎是预防或治疗糖尿病的一种有前途的治疗选择。血糖水平。需要更广泛的研究来确认所涉及的机制以及持续服用这些药物的效果是否可持续。进一步的研究是有必要的。
OBJECTIVE: To review the evidence base supporting the use of salicylates for glucose level control in patients with type 2 diabetes and provide a comprehensive review of available information describing the potential role of salicylates and, in particular, salsalate, for glucose control in type 2 diabetes prevention and treatment.DATA SOURCES: A literature search using MEDLINE (1966 March 2010), PubMed, and Google Scholar was conducted using the search terms salicylates, salicylic acid, aspirin, salsalate, acetylsalicylic acid, insulin, glucose, glycemic control, diabetes, hyperglycemia, and nuclear factor. The bibliographies of identified articles were reviewed for additional citations.STUDY SELECTION AND DATA EXTRACTION: All relevant English-language information on the pharmacology, efficacy, and safety of salicylates for glucose control related to insulin resistance or diabetes prevention were reviewed. Preclinical data, clinical trials, and case reports were identified, evaluated, and included in this systematic review.DATA SYNTHESIS: Treatment of inflammation may be a potential novel strategy in prevention and treatment of type 2 diabetes, in which the body is resistant to the effects of insulin. Previous and recent studies reveal a possible relationship between inflammation and obesity. The chronic activation of the immune system due to low-grade inflammation was found in several studies to be associated with obesity, and this, in turn, can promote development of insulin resistance and impaired glucose tolerance. Administration of salicylates was shown over a century ago to lower glucose levels in patients with diabetes. Many in vitro and in vivo pharmacologic studies have demonstrated a glucose-lowering effect of salicylates. Salicylates, especially salsalate, were found in several clinical studies and case reports to be potential agents for diabetes treatment with a favorable safety profile. Although these studies had inherent limitations, such as small numbers of patients and short duration, the vast majority showed significant glucose-lowering effects. A large randomized trial, the National Institute of Diabetes and Digestive and Kidney Diseases sponsored Targeting Inflammation with Salsalate in Type 2 Diabetes (TINSAL-T2D) trial, recently concluded that salsalate lowers hemoglobin A(1c) levels and improves glycemic control in patients with type 2 diabetes.CONCLUSIONS: Salicylates, especially salsalate, appear to be a promising treatment option for prevention or treatment of diabetes by lowering glucose levels. More extensive studies are needed to confirm the mechanisms involved and whether the effects are sustainable with continued administration of these agents. Further studies are warranted.