天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (2): 203-207.doi: 10.11958/20200931

• 药物临床观察 • 上一篇    下一篇

参苓白术散联合二甲双胍对2型糖尿病肥胖者miR-146a、GLP-1及血脂的影响 #br#

彭俊华，葛锁华 ，张欢妍，于雪冰，孙露阳
  

  1. 1江苏大学附属金坛区人民医院检验科（邮编213200），2内分泌科
  • 收稿日期:2020-04-10 修回日期:2020-11-06 出版日期:2021-02-15 发布日期:2021-02-02
  • 通讯作者: 彭俊华 E-mail:junhua_p@126.com
  • 基金资助:
    常州市科技支撑计划（社会发展）

The influence of shenling baizhu powder and metformin on miR-146a, GLP-1 and blood lipid in type 2 diabetes mellitus obesity #br#

PENG Jun-hua, GE Suo-hua, ZHANG Huan-yan, YU Xue-bing, SUN Lu-yang   

  • Received:2020-04-10 Revised:2020-11-06 Published:2021-02-15 Online:2021-02-02
  • Contact: jun hua PENG E-mail:junhua_p@126.com

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摘要： 目的探讨参苓白术散联合二甲双胍对 2 型糖尿病（T2DM）肥胖患者的 miR-146a、胰高血糖素样肽-1
（GLP-1）及血脂的影响。 方法将86例T2DM肥胖者按照随机数字表法分为试验组（参苓白术散+二甲双胍治疗）和
对照组（二甲双胍治疗）；2组均持续治疗6个月，并分别采集患者用药前、用药1周、用药3个月和用药6个月的静脉
血，荧光定量聚合链式反应检测miR-146a表达，生化法检测血脂水平，酶联免疫吸附测定法检测血GLP-1和白细胞
介素（IL）-12水平。 结果与对照组比较，试验组在用药3个月后miR-146a、GLP-1水平升高，IL-12水平降低，用药
6个月血清总胆固醇（TC）和三酰甘油（TG）明显降低（P＜0.05）。随着治疗时间的延长，试验组和对照组miR-146a和
GLP-1均呈升高趋势，IL-12呈下降趋势（P＜0.05），试验组TG、TC、低密度脂蛋白胆固醇（LDL-C）水平及体质量指数
用药3个月时均下降（P＜0.05）。T2DM的miR-146a表达水平与血清GLP-1水平呈正相关（r=0.874，P＜0.01），与IL-
12、TC、TG、LDL-C水平呈负相关（r分别为-0.744、-0.456、-0.397及-0.629，P＜0.01）。血清GLP-1水平与IL-12、TC、
TG和LDL-C水平呈负相关（r分别为-0.807、-0.482、-0.452及-0.693，P＜0.01）。 结论参苓白术散联合二甲双胍能
更有效改善T2DM肥胖患者的TC和TG水平，作用机制可能与提高miR-146a和GLP-1水平、降低炎性因子IL-12的
水平有关。

关键词: 糖尿病, 2型, 参苓白术散, 肥胖症, 二甲双胍, 血脂异常, 胰高血糖素样肽1, miR-146a

Abstract: ObjectiveTo study the influence of shenling baizhu powder and metformin on the miR-146a, glucagon like
peptide-1(GLP-1), interleukin-12 (IL-12) and serum total cholesterol (TC), triglyceride(TG) and low density lipoprotein
cholesterol (LDL-C) in type 2 diabetic mellitus (T2DM) obesity. MethodsA total of 86 patients with T2DM obesity were divided
into experimental group (patients treated with shenling baizhu powder and metformin) and control group (patients treated with
metformin) by randomly method. The treatment lasted for 6 months. The venous blood samples of patients were collected on the
day before treatment, 1 week, 3 months and 6 months after treatment. miR-146a was detected by qPCR, and the level of blood
lipid was detected by biochemical colorimetry, the serum levels of GLP-1 and IL-12 were detected by enzyme linked
immunosorbent assay (ELISA). ResultsCompared with the control group, the levels of miR-146a and GLP-1 were increased,
serum IL-12 was decreased three months after treatment in experimental group, while the serum levels of TC and TG were also
decreased six months after treatment (P＜0.05). With the prolongation of treatment time, the serum levels of miR-146a and GLP-
1 showed an increasing trend in experimental group and control group (P＜0.05), while the level of IL-12 showed a decreasing
trend in experimental group and control group (P＜0.05). The serum levels of TC, TG, LDL-C and body mass index (BMI) were
started decreasing 3 months after treatment in experimental group (P＜0.05). The expression level of miR-146a was positively
correlated with serum GLP-1 levels in T2DM (r=0.874, P＜0.01), and negatively correlated with IL-12, TC, TG and LDL-C levels
(r= -0.744, -0.456, -0.397 and -0.629, P＜0.01). The serum level of GLP-1 was negatively correlated with IL-12, TC, TG and
LDL-C levels (r = -0.807, -0.482, -0.452 and -0.693, P＜0.01). Conclusion The shenling baizhu powder combined with metformin can effectively improve serum levels of TG and TC in T2DM obesity. The mechanism may be related with increasing
the levels of miR-146a and GLP-1, decreasing the inflammatory factors and IL-12 level.

Key words: diabetes mellitus, type 2, Shenling baizhu powders, obesity, metformin, dyslipidemias, glucagon-like peptide 1, miR-146a

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