Effects of Vildagliptin or Pioglitazone on Glycemic Variability and Oxidative Stress in Patients with Type 2 Diabetes Inadequately Controlled with Metformin Monotherapy: A 16-Week, Randomised, Open Label, Pilot Study.
Effects of Vildagliptin or Pioglitazone on Glycemic Variability and Oxidative Stress in Patients with Type 2 Diabetes Inadequately Controlled with Metformin Monotherapy: A 16-Week, Randomised, Open Label, Pilot Study.
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DOI：
10.3803/enm.2017.32.2.241
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发表时间：
2017-06
期刊：
影响因子：
--
通讯作者：
Kim SG
中科院分区：
文献类型：
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作者：
Kim NH;Kim DL;Kim KJ;Kim NH;Choi KM;Baik SH;Kim SG
通过激活氧化应激，Glycosidase变异性与糖尿病并发症的发展相关。本研究旨在评价二肽基肽酶4抑制剂vildagelide或噻唑烷二酮吡格列酮对2型糖尿病患者血糖变异性和氧化应激的影响。在这项开放标签、随机化、活性对照、初步试验中，二甲双胍单药治疗控制不佳的个体被分配至vildagelatin（50 mg每日两次，n = 17）或吡格列酮（15 mg每日一次，n = 14）治疗组，持续16周。通过计算血糖波动的平均幅度（法师）评估血糖变异性，该幅度从连续血糖监测中获得。尿8-异前列腺素F2 α、血清氧化低密度脂蛋白和高敏C反应蛋白被用作氧化应激或炎症的标志物。在16周的治疗期间，维达鲁肽和吡格列酮均显著降低糖化血红蛋白和平均血糖水平。维达利还显著降低了法师（从93.8 ± 38.0降至70.8 ± 19.2 mg/dL，P = 0.046）和24小时血糖的平均标准差（从38 ± 17.3降至27.7 ± 6.9，P = 0.026）;然而，吡格列酮没有降低，尽管两组的下降幅度相似。两组治疗后氧化应激或炎症标志物（包括尿8-异前列腺素F2 α）均未发生变化。在这项为期16周的治疗试验中，虽然没有观察到氧化应激标志物的减少，但在二甲双胍单药治疗控制不佳的2型糖尿病患者中，vildaglavine（而不是吡格列酮）降低了血糖变异性。
Glycemic variability is associated with the development of diabetic complications through the activation of oxidative stress. This study aimed to evaluate the effects of a dipeptidyl peptidase 4 inhibitor, vildagliptin, or a thiazolidinedione, pioglitazone, on glycemic variability and oxidative stress in patients with type 2 diabetes. In this open label, randomised, active-controlled, pilot trial, individuals who were inadequately controlled with metformin monotherapy were assigned to either vildagliptin (50 mg twice daily, n=17) or pioglitazone (15 mg once daily, n=14) treatment groups for 16 weeks. Glycemic variability was assessed by calculating the mean amplitude of glycemic excursions (MAGE), which was obtained from continuous glucose monitoring. Urinary 8-iso prostaglandin F2α, serum oxidised low density lipoprotein, and high-sensitivity C-reactive protein were used as markers of oxidative stress or inflammation. Both vildagliptin and pioglitazone significantly reduced glycated hemoglobin and mean plasma glucose levels during the 16-week treatment. Vildagliptin also significantly reduced the MAGE (from 93.8±38.0 to 70.8±19.2 mg/dL, P=0.046), and mean standard deviation of 24 hours glucose (from 38±17.3 to 27.7±6.9, P=0.026); however, pioglitazone did not, although the magnitude of decline was similar in both groups. Markers of oxidative stress or inflammation including urinary 8-iso prostaglandin F2α did not change after treatment in both groups. In this 16-week treatment trial, vildagliptin, but not pioglitazone, reduced glycemic variability in individuals with type 2 diabetes who was inadequately controlled with metformin monotherapy, although a reduction of oxidative stress markers was not observed.