主页 > 医药科学 >
【文摘发布】2型糖尿病患者体重增加的潜在原因
Author：Jacob AN, Salinas K, Adams-Huet B, Raskin P.
Resource: Diabetes Obes Metab. 2007 May;9(3):386-93.
Abstract：Objective: To investigate the potential causes of weight gain using insulin and combination therapy in type 2 diabetes. Design and methods: This was an open-label prospective study of 6-month duration. Randomization was performed to insulin monotherapy, insulin and pioglitazone 30 mg daily, or insulin and metformin up to 2000 mg daily. Fifty-seven subjects with poorly controlled type 2 diabetes were enrolled. The goal was to achieve a normal haemoglobin A1c (HbA1c) (<5.6%). Weight, resting energy expenditure (REE), reported energy intake and total energy expenditure, HbA1c, glycosuria, plasma leptin, ghrelin and adiponectin levels, and body fat were measured. Results: A total of 49 subjects completed the study. At baseline, weight was 89.4 +/- 22.9 kg and HbA1c was 11.1 +/- 1.5%. Weight increased by 7.46, 7.60 and 7.12 kg in the monotherapy, metformin and pioglitazone groups, respectively [p = 0.98 between and <0.0001 within the groups by repeated measures-analysis of variance (RM-anova)]. HbA1c dropped to 7.8 +/- 0.9% in the monotherapy arm, 7.6 +/- 1.0% in the metformin arm and 7.2 +/- 1.2% in the pioglitazone arm. Reported energy intake decreased. Glycosuria decreased but was not correlated with weight gain, while HbA1c changes were correlated with weight gain. REE per lean mass decreased (p = 0.04 by RM-anova). The subcutaneous fat areas in the insulin monotherapy and pioglitazone arms showed increases (p = 0.02 and 0.004 respectively). Conclusions: Weight gain was probably not due to an increase in food intake, while REE per lean body mass decreased, suggesting a role for increased efficiency in fuel usage due to improved glycaemic control. A drop in glycosuria probably also contributed to weight gain. In the monotherapy and pioglitazone arms, the subcutaneous fat areas increased.
PMID: 17391167 尝试翻译下:
2型糖尿病患者体重增加的原因
摘要:目的:研究2型糖尿病患者应用胰岛素联合治疗体重继续增加的潜在原因
实验设计与方法:这是一个维期6个月的前瞻性研究.实验随机分为单用胰岛素治疗组,胰岛素联合吡格列酮每日30毫克组,及胰岛素联用二甲双胍每日高达2000毫克组.有57例控制不佳的2型糖尿病患者入选.实验的目标是达到一个正常的HbA1c (<5.6%).这些入选者均检测体重,静息时能量消耗(REE),能量摄入及总共能量消耗, HbA1c,尿糖,血浆来普照汀水平,以及体脂肪含量.
结果:一共有48例完成了该实验.基线水平上,体重为89.4 +/- 22.9 kg , HbA1c 为 11.1 +/- 1.5%.在单用胰岛素治疗组\联用二甲双胍组及吡格列酮组中体重分别增加了7.46, 7.60 及 7.12 kg,P值=0.98,三组间应用方差分析方法. HbA1c在三组中分别降至7.8 +/- 0.9%,7.6 +/- 1.0%及7.2 +/- 1.2%.能量摄入也下降.尿糖降低,但是与体重增加无关,而HbA1c的改变则与体重增加有关. REE也明显下降(p = 0.04).皮下脂肪在单用胰岛素组及联用吡格列酮组显示出明显减少(P分别等于0.02 和0.004)
结论:体重的增加可能并不由于食物摄入的增加所致,而REE也急剧下降.提示增加能量利用的原因是提高了对血糖的控制.而尿糖的降低也可以促进体重的增加.在单用胰岛素治疗及联用吡格列酮治疗时其皮下脂肪均有增加. [标签:content1][标签:content2]
阅读本文的人还阅读：
作者:admin@医学,生命科学 2011-03-01 05:11
医学,生命科学网