磺脲类降糖药格列齐特剂量与血脂学相关性研究

目的：探讨2型糖尿病（T2DM）磺脲类口服降糖药剂量与血脂学指标异常之间的关系。方法：选择76例T2DM患者，均口服格列齐特共计57d，药物剂量逐渐增大至血糖达标或格列齐特达240mg／d，所有观察对象的最大用药量（DI）经体质量校正后排序，以50百分位数分为小剂量A组、大剂量B组，比较2组一般情况及血脂情况。结果：（1）2组除体质量指数（BMI）外，其余基线指标差异无统计学意义。（2）2组除TC外，DI、TG、HDL-C、LDL-C、TG／HDL-C及AIP差异均有统计学意义。（3）单因素直线相关分析DI与动脉硬化指数（AIP）、TG／HDL呈正相关（P〈0．01）；DI与BMI呈负相关（P〈0．01）。（4）DI（Y）与血脂指标及其他各因素（X）作多元逐步回归分析，AIP（X1）、体质量（X2）、胆固醇（X3）、TG／HDL-C（X4）。回归方程：Y=6．011X1-0．0346X2-0．0217X3-0．66X4＋4．022。结论：血脂异常与T2DM患者格列齐特用量具有良好的相关性，T2DM患者磺脲口服降糖药剂量大小与脂毒性有关。

The Investigation of the Relationship between the Sulfonlureand Abnormal Blood-fat

Objective: To investigate the relationship between the dosage of sulfolure and abnormal serum lipids in patients with T2 DM. Methods: 76 type 2 DM patients were included. Every patient took gliclazide for 57 days and the dose was gradually increased until 240 mg/d or serum glucose was normal .A order was set up for the largest dosage which was revised by body weight and all patients were divided into two groups(the small dosage group A and the great dosage group B) according to the P 50.The clinical feature and serum lipids in both groups were compared. Results: There were no differences of the base indicator except for BMI found between two groups. There was significant variation of serum level of DI?TG?HDL-C?LDL-C?TG/HDL-C and AIP except for TC between group A and B. Single factor linear analysis demonstrated that positive correlation was between DI and AIP?TG/HDL-C(P < 0.01) and negative correlation was between DI and BMI (P < 0.01). Multiple stepwise regression analysis was made with DI and index of serum lipids and other factors such as AIP(X1), body mass(X2),TC(X3) and TG/HDL-C(X4).The regression equation is Y= 6.011 X1-0.0346 X2-0.0217 X3-0.66 X4+4.022. Conclusion: There is significant correlation between the dosage of gliclazide and abnormal serum lipids in patients with T2 DM. The dosage of sulfolure is associated with lipotoxicity.