目的:2型糖尿病(T2DM)是由胰岛素抵抗或组织对胰岛素不敏感引起的,以及相对胰岛素不足。长时间不受控制的糖尿病与大量合并症和器官损伤有关。本研究的目的是评估omega-3脂肪酸与格列美脲联合给药对血糖的影响,血脂谱,血清irisin,2型糖尿病患者的sirtuin-1水平。
方法:这项临床试验涉及70名2型糖尿病患者,随机分配给3毫克格列美脲和含有1000毫克鱼油的omega-3胶囊,13%的二十碳五烯酸(EPA)和9%的二十二碳六烯酸(DHA)(omega-3组,n=35)或安慰剂胶囊含有玉米油和亚油酸(对照组,n=35),每天三个月。在研究开始时和12周后获得血液样本,用于HbA1c%的生化检查,FBG,空腹胰岛素,和脂质分布。此外,计算血浆致动脉粥样硬化指数(AIP)。在干预前后,使用人酶联免疫吸附测定(ELISA)试剂盒评估血清irisin和sirtuin-1水平。
结果:与对照组相比,ω-3脂肪酸降低血清空腹血糖(FBG,p<0.001),糖化血红蛋白百分比(HbA1C%,p<0.001),总胆固醇(TC,p<0.001),甘油三酯(TG,p=0.006),低密度脂蛋白(LDL,p=0.089),和胰岛素抵抗的稳态模型评估(HOMA-IR,干预三个月后,p=0.021)。然而,据报道,干预后两组的血清irisin和高密度脂蛋白(HDL)均显著升高(分别为p=0.026和p=0.007).血浆动脉粥样硬化指数(AIP)在对照组中增加,但在omega-3组中降低,两组之间存在显着差异(p<0.001)。
结论:本研究发现补充omega-3脂肪酸可能会大大提高血液中的irisin水平,以及使用格列美脲改善2型糖尿病患者的血糖控制和血脂状况。
背景:本研究在ClinicalTrials.gov上注册,标识符为NCT03917940。(注册日期:2019年4月17日)。
OBJECTIVE: Type 2 diabetes mellitus (T2DM) is caused by insulin resistance or tissue insensitivity to insulin, as well as relative insulin insufficiency. Diabetes that is uncontrolled for an extended period of time is linked to substantial comorbidities and organ damage. The purpose of the current
study is to assess the effect of coadministration of omega-3 fatty acids with glimepiride on blood glucose, lipid profile, serum
irisin, and sirtuin-1 levels in T2DM patients.
METHODS: This clinical
trial involved 70 type 2 diabetic patients randomly assigned to glimepiride 3 mg with either omega-3 capsules contained fish oil 1000 mg, 13% of eicosapentaenoic acid (EPA) and 9% docosahexaenoic acid (DHA) (omega-3 group, n = 35) or placebo capsules contained corn oil and linoleic acid (control group, n = 35) daily for three months. Blood samples were obtained at the start of the
study and 12 weeks later for biochemical examination of HbA1c%, FBG, fasting insulin, and lipid profile. In addition, the atherogenic index of plasma (AIP) was calculated. Human enzyme-linked immunosorbent assay (ELISA) kits were utilized for assessing serum irisin and sirtuin-1 levels before and after the intervention.
RESULTS: Compared to the control group, omega-3 fatty acids decreased serum fasting blood glucose (FBG, p < 0.001), glycated hemoglobin percent (HbA1C%, p < 0.001), total cholesterol (TC, p < 0.001), triglycerides (TGs, p = 0.006), low density lipoprotein (LDL, p = 0.089), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR, p = 0.021) after three months of intervention. However, a significant increase was reported in serum irisin and high density lipoprotein (HDL) between both groups after intervention (p = 0.026 and p = 0.007, respectively). The atherogenic index of plasma (AIP) increased in the control group but decreased in the omega-3 group, with significant differences between the two groups (p < 0.001).
CONCLUSIONS: The present study found that supplementing with omega-3 fatty acids might dramatically enhance blood irisin levels, as well as improve glycemic control and lipid profile in type 2 diabetes mellitus patients using glimepiride.
BACKGROUND: This
study is registered on ClinicalTrials.gov under identifier NCT03917940 . (The registration date: April 17, 2019).