摘要
目的:观察糖尿病前期患者应用二甲双胍降糖治疗或强化生活方式干预前后血清、高敏C反应蛋白(hs-CRP)及胰岛素敏感指数水平变化情况。方法:筛选糖尿病前期患者176例,随机分成二甲双胍治疗组、强化生活方式干预组和对照组,二甲双胍治疗组52例,在一般生活方式干预基础上给予二甲双胍片口服;强化生活方式干预组60例,根据个人饮食习惯为基础,制定热能。给予低脂饮食,控制饮食,配合适当的体育锻炼。对照组64例,仅给予一般生活方式干预。测定干预治疗前后的空腹血糖、餐后2 h血糖、糖化血红蛋白、体重指数、血脂、hs-CRP、胰岛素敏感指数变化。结果:经干预治疗2年后,对照组糖耐量转为正常21例(32.81%),转为糖尿病12例(18.75%);二甲双胍组糖耐量转为正常41例(78.85%),转为糖尿病3例(5.77%),强化生活方式干预组转为正常32例(53.33%),转为糖尿病4例(6.67%)。与对照组相比,二甲双胍组及强化生活方式干预组的糖尿病发生率差异有统计学意义(P<0.05)。干预治疗2年后,二甲双胍治疗组及强化生活方式干预组各项指标均有明显变化,且二甲双胍治疗组效果优于强化生活方式干预组(P<0.01)。结论:糖尿病前期时,血清hs-CRP水平已经开始升高,且胰岛素敏感性下降,二甲双胍降糖治疗或强化生活方式干预均能明显减低血糖,并降低血清C反应蛋白(CRP)水平,改善胰岛素敏感性,二甲双胍作用更明显。
AIM： To observe the changes of the serum high sensitive C-reactive protein（hs-CRP） levels and the insulin sensitivity index before and after using Metformin or intensive lifestyle intervention treatment. METHODS： 176 prediabetes patients were randomly divided into Metformin treatment group,intensive lifestyle intervention group and Control Group.Metformin treatment group 52 cases,in general,was given on the basis of lifestyle intervention of Metformin tablets;The intensive lifestyle intervention group 60 cases,based on individual eating habit,and was developed energy,given low-fat diet,control diet,with a reasonable,balanced diet,coupled with adequate physical exercise.64 patients in the Control Group,only to give general lifestyle intervention.The fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin,body mass index,blood lipids,hs-CRP,insulin sensitivity index changes were determined before and after intervention.RESULTS：After intervention for 2 years,21 impaired glucose tolerance patients（32.81%）became normal glucose tolerance,and 12 patients（18.75%） were converted to diabetes patients in the Control Group.41 impaired glucose tolerance patients（78.85%）became normal glucose tolerance,and 3 patients（5.77%） were converted to diabetes patients in the metformin treatment group.32 impaired glucose tolerance patients（53.33%）became normal glucose tolerance,and 4 patients（6.67%） were converted to diabetes patients in intensive lifestyle intervention group.Compared with the Control Group,the incidence of diabetes was significant in the Metformin treatment group and intensive lifestyle intervention group（P0.05）.After intervention for 2 years,the changes of the indexes were significant in the Metformin treatment group and intensive lifestyle intervention group（P0.01）.The Metformin treatment group had better results than intensive lifestyle intervention group（P0.01）.CONCLUSION： Prediabetes,the serum hs-CRP levels have been increased,and the insulin sensitivity has been decreased,metformin or intensive lifestyle intervention therapy can significantly reduce the blood sugar and the serum hs-CRP levels and improve the insulin sensitivity,and the Metformin effects is obvious.
出处
《中国临床药理学与治疗学》
CAS
CSCD
2011年第8期920-924,共5页
Chinese Journal of Clinical Pharmacology and Therapeutics
基金
浙江省丽水市科学技术局科技计划项目(丽科(2007)70号文件)
