1 吉林大学第二医院内分泌科，长春 130000
目的：探讨双歧杆菌四联活菌片对初诊超重2型糖尿病(Type 2 diabetes mellitus，T2DM)患者血糖、血脂、Toll样受体4(Toll-like receptor 4，TLR4)的影响。方法：选取2019年1月至6月就诊的初诊T2DM患者，符合24.0 kg/m²≤体重指数(body mass index，BMI)<28.0 kg/m²，将入选患者按照1:1随机分为对照组(50例)和观察组(50例)。两组均给予饮食指导及适量运动等建议，对照组给予盐酸二甲双胍片(1 500 mg/d)治疗，观察组在对照组的基础上予以双歧杆菌四联活菌片(3片/次，3次/日)治疗，两组均治疗3个月。统计两组患者最终纳入数。比较两组治疗前后空腹血糖(fasting plasma glucose，FPG)、餐后2 h血糖(2-hour postprandial blood glucose，2hPG)、糖化血红蛋白(glycosylated hemoglobin，HbA1c)、总胆固醇(total cholesterol，TC)、三酰甘油(triglyceride，TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol，LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol，HDL-C)、空腹胰岛素(fasting insulin，FINS)、稳态胰岛素评价指数(homeostasis model assessment-insulin resistance，HOMA-IR)、TLR4等指标的差异。结果：在治疗研究过程中，对照组退出7例，观察组退出5例，最终对照组纳入43例，观察组纳入45例。治疗3个月后，两组患者FPG，2hPG，HbA1c，TG，FINS，HOMA-IR，TLR4较前下降，HDL-C较前升高，且观察组下降/升高更明显(均P<0.05)；两组患者TC，LDL-C均较前下降，但两组治疗后差异无统计学意义(均P>0.05)。结论：双歧杆菌四联活菌片辅助口服降糖药在超重T2DM患者中应用效果良好，能够改善患者的血糖、血脂水平，降低TLR4水平，有一定的临床意义。
Effect of bifidobacterium tetragenous viable bacteria tablets on newly diagnosed overweight type 2 diabetes on glucose and lipid metabolism and Toll-like receptor 4
CorrespondingAuthor: ZHAO Shujie
This work was supported by Jilin Natural Science Foundation, China (3D5195794429).
Objective: To investigate the effect of bifidobacterium tetragenous viable bacteria tablets on newly diagnosed overweight type 2 diabetes on blood glucose, blood lipid and Toll-like receptor 4 (TLR4). Methods: Newly diagnosed Type 2 diabetic patients who were diagnosed from January 2019 to June 2019 were selected, which met 24.0 kg/m² ≤body mass index (BMI)<28.0 kg/m². The selected patients were randomly divided into two groups according to 1:1, and the control group was 50 cases, observation group of 50 cases. Both groups were given basic treatments such as dietary guidance and proper exercise. The control group was given metformin hydrochloride tablets (1 500 mg/day). The observation group was treated with bifidobacterium tetragenous viable bacteria tablets (3 tablets/time, 3 times/day) on the basis of the control group. Both groups were treated for 3 months. The number of patients included in the 2 groups was counted. Fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), fasting insulin (FINS), homeostasis model assessment-insulin resistance (HOMA-IR), and TLR4 were compared before and after treatment in the 2 groups. Results: During the study, 7 patients were withdrawn from the control group, 5 patients were withdrawn from the observation group, 43 patients were eventually included in the control group, and 45 patients were included in the observation group. After 3 months of treatment, FPG, 2hPG, HbA1c, TG, FINS, HOMA-IR, and TLR4 decreased in the 2 groups, HDL-C was higher than before, and the observation group decreased/increased significantly (all P<0.05). The TC and LDL-C of the 2 groups were lower than before, but there was no significant difference between the 2 groups after treatment (all P>0.05). Conclusion: The bifidobacterium tetragenous viable bacteria tablets supplemented oral hypoglycemic agent is good for the overweight type 2 diabetes patients, and can improve blood sugar and blood lipid levels, ae well as reduce TLR4 levels, which has a certain clinical significance.
bifidobacterium tetragenous viable bacteria tablets; overweight diabetes; Toll-like receptor 4; insulin resistance