Objective To evaluate the effects of saxagliptin on β cell function of type 2 diabetic patients. Methods The Cochrane Library, PubMed, EMbase, CBM, VIP, and CNKI were searched from their establishment to November, 2011, for relevant randomized controlled trials on the effects of saxagliptin on β cell function in type 2 diabetic patients. Language was limited to Chinese and English only. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated and cross-checked the methodological quality. Then meta-analysis was conducted using RevMan 5.0 software. Results Five RCTs were included. The results of meta-analysis showed that: HOMA-B was significantly increased in the saxagliptin (or saxagliptin plus routine treatment) 2.5 mg, 5 mg, and 10 mg groups (MD=8.03, 95%CI 4.57 to 11.48, Plt;0.000 01; MD=7.50, 95%CI 4.27 to 10.73, Plt;0.000 01; MD=17.45, 95%CI 13.93 to 20.97, Plt;0.000 01); HOMA-IR was similar between saxagliptin 2.5 or 10 mg group, and control group (MD= –0.05, 95%CI –0.18 to 0.08, P=0.47; MD= –0.18, 95%CI –0.60 to 0.24, P=0.4). Conclusion Current evidence shows that saxagliptin is effective in improving β cell function and insulin resistance. Due to short follow-up and small sample size, this conclusion has to be further proved by more high-quality RCTs.
目的:探讨老年2型糖尿病患者体重指数(BMI)与胰岛β功能状态及胰岛素抵抗(RI)的关系。方法:调查对象为2006年4月~2008年7月入我接受健康体检的成都地区离退休干部。采用1999年WHO糖尿病诊断标准,以129例已确诊T2DM患者为观察对象,根据体重指数(BMI)分为两组:肥胖组(含超重)(BMI≥25)66例,均为男性;非肥胖组(BMIlt;25)63例,其中3例为女性(无统计学意义),并与19例正常对照组进行对比研究。以氧化酶法测定空腹血葡萄糖(FBG),酶联免疫法测胰岛素(INS)及C肽(CP)水平等参数。用HOMA公式计算胰岛素抵抗(IR)和β细胞功能指数(BCI)。采用SPSS软件进行方差分析(ANOVA),分析3组间各指标的差异显著性x-±S表示。结果:三组经HOMA 公式计算的IR值为对照组(3.0±1.3)、非肥胖组(4.6±4.0)、肥胖组(5.2±6.2)依次递增,但各组间无显著性差异。HOMAβ细胞功能指数为非肥胖组(82.06±84.1)、肥胖组(138.4±179.6)、对照组(226.5±236.8)依次递增,各组间均有显著性差异(Plt;0.01～0.05)。 结论:老年2型糖尿病患者普遍存在β细胞功能减退,尤其是非肥胖组;同时也具有胰岛素抵抗,主要是肥胖组。表明BMI对老年糖尿病患者胰岛β细胞功能有影响,肥胖患者β细胞分泌能力加强,负担加重,功能受损,胰岛素抵抗明显。