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纸质出版:2014
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谢洁,蒲丹岚,张莉,廖涌,胡治勇,胡昌伦.厄贝沙坦对2型糖尿病合并高血压患者胰岛素抵抗及胰岛β细胞功能的影响[J].陆军军医大学学报(原第三军医大学学报),2014,36(15):1635-1638.
Xie Jie,Pu Danlan,Zhang Li,Liao Yong,Hu Zhiyong,Hu Changlun.Effects of irbesartan on insulin resistance and β-cell function in patients with type 2 diabetes mellitus complicated with hypertension[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(15):1635-1638.
谢洁,蒲丹岚,张莉,廖涌,胡治勇,胡昌伦.厄贝沙坦对2型糖尿病合并高血压患者胰岛素抵抗及胰岛β细胞功能的影响[J].陆军军医大学学报(原第三军医大学学报),2014,36(15):1635-1638. DOI:
Xie Jie,Pu Danlan,Zhang Li,Liao Yong,Hu Zhiyong,Hu Changlun.Effects of irbesartan on insulin resistance and β-cell function in patients with type 2 diabetes mellitus complicated with hypertension[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(15):1635-1638. DOI:
目的 观察厄贝沙坦对2型糖尿病(type 2 diabetes mellitus
T2DM)合并高血压患者胰岛素抵抗(insulin resistance
IR)及胰岛β细胞功能的影响。 方法 将94例初发T2DM合并高血压患者随机分为两组(n=47):厄贝沙坦组、苯磺酸氨氯地平组,分别给予厄贝沙坦和苯磺酸氨氯地平治疗12周。比较治疗前后两组患者体质量指数(body mass index
BMI)、腰围(waist circumference
WC)、血压(blood pressure
BP)、空腹血糖(fasting blood glucose
FBG)、空腹胰岛素(fasting plasma insulin
FINS)、糖化血红蛋白(glycosylated hemoglobin
HbA1c)、甘油三酯(triglyeride
TG)、总胆固醇(total cholesterol
TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol
LDL-c),并采用稳态模式评估法计算胰岛素抵抗指数(HOMA- HOMA-insulin resistance index
HOMA-IR)、胰岛素分泌指数(HOMA-β cell Secretion index
HOMA-β)及治疗前后的变化。 结果 治疗12周后,两组患者治疗后的BP、FBG、HbA1c均较治疗前降低(均
P
0.05),两组患者治疗后的胰岛素分泌指数均较治疗前升高(均
P
0.05),两组治疗前后WC、BMI、TG、TC、LDL-c、HDL-c差异均无统计学意义(均
P
0.05)。厄贝沙坦组治疗后胰岛素抵抗指数较治疗前下降[3.79(2.51~4.99)vs 4.58(3.38~5.94)
P0.05
]
,氨氯地平组治疗前后胰岛素抵抗指数差异无统计学意义[3.90(2.52~5.26)vs 3.90(2.52~5.26)
P
0.05
]
。 结论 厄贝沙坦在降低血压的同时,可能改善T2DM患者的胰岛素抵抗。
Objective To determine the effects of irbesartan on insulin resistance and islet β-cell function in the pat
ients with type2 diabetes mellitus (T2DM) complicated with hypertension. Methods Ninety-four patients with newly diagnosed T2DM complicated with hypertension admitted in our hospital from November 2011 to March 2012 were prospectively enrolled in this study. They were randomly assigned into 2 groups and received either irbesartan (150 to 300 mg/d) or amlodipine (5 to 10 mg/d) treatment for 12 weeks. The clinical characteristics
such as body mass index (BMI)
waist circumference (WC)
blood pressure (BP)
fasting plasma glucose (FBG) and insulin (FINS)
and serum levels of glycosylated hemoglobin (HbA1c)
triglyeride (TG)
total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c) were collected before and after treatment. Homeostasis model assessment (HOMA) was used to calculate the insulin resistance index (HOMA-IR=fasting serum insulin fasting serum glucose/22.5) and insulin secretion index (HOMA-β=fasting serum insulin×20/ fasting glucose-3.5). Results After 12 week treatment
the BP
FBG and HbA1c were decreased
while the insulin secretion index was significantly increased in both groups (
P
0.05). There was no significant difference in the WC
BMI
TC
LDL-c and HDL-c in the 2 groups before and after the treatment (
P
0.05). The insulin resistance index was obviously decreased in irbesartan group after the treatment [3.79 (2.51 to 4.99) vs 4.58 (3.38 to 5.94)
P
0.05
]
while there was no obvious alteration in the amlodipine group [3.90 (2.52 to 5.26) vs 3.90 (2.52 to 5.26)
P
0.05
]
. Conclusion While effectively controlling the blood pressure
irbesartan can improve the insulin resistance in T2DM patients.
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