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  • 朱英倩,江 华,沙雯君,等.盐酸小檗碱对初发2型糖尿病患者降糖疗效及肠道菌群的影响[J].同济大学学报(医学版),2020,41(4):467-472.    [点击复制]
  • ZHU Ying-qian,JIANG Hua,SHA Wen-jun,et al.Effect of berberine on hypoglycemic effect and gut microbiota in patients with newly diagnosed type 2 diabetes mellitus[J].同济大学学报(医学版),2020,41(4):467-472.   [点击复制]
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盐酸小檗碱对初发2型糖尿病患者降糖疗效及肠道菌群的影响
朱英倩,江华,沙雯君,雷涛
0
(同济大学附属东方医院老年医学科,上海 200120;上海中医药大学附属普陀医院内分泌科,上海 200333)
摘要:
目的 观察盐酸小檗碱对初发2型糖尿病患者血糖、胰岛素抵抗、胰高血糖素样肽-1(glucagon-like peptide-1, GLP-1)以及肠道菌群影响。方法 选取50例初发2型糖尿病患者,随机、双盲分为小檗碱组25例和对照组25例,于0、12周检测空腹血糖(fasting blood glucose, FBG)、糖化血红蛋白(glycated hemoglobin A1c, HbA1c)、空腹胰岛素(fasting insulin, FINS)、胰岛素抵抗指数(homeostasis model assessment-Insulin resistance, HOMA-IR)、GLP-1以及肠道菌群变化。结果 两组干预前后对比,FBG、HbA1c、FINS、HOMA-IR下降,GLP-1升高,差异有统计学意义(P<0.05);干预后小檗碱组与对照组相比,FBG、HbA1c、HOMA-IR下降、GLP-1升高(P<0.05);肠道双歧杆菌、乳酸杆菌升高,肠球菌下降(P<0.05);拟杆菌、肠杆菌下降,差异有统计学意义(P<0.01);双歧杆菌、乳酸杆菌与FBG水平呈负相关,肠杆菌与FBG水平呈正相关,差异有统计学意义(P<0.05)。结论 盐酸小檗碱对初发2型糖尿病患者降糖疗效较好并能够有效改善肠道菌群紊乱
关键词:  小檗碱  2型糖尿病  肠道菌群  胰高血糖素样肽-1  血糖
DOI:10.16118/j.1008-0392.2020.04.011
投稿时间:2019-09-12
基金项目:上海市卫生和计划委员会科研课题(201640206)
Effect of berberine on hypoglycemic effect and gut microbiota in patients with newly diagnosed type 2 diabetes mellitus
ZHU Ying-qian,JIANG Hua,SHA Wen-jun,LEI Tao
(Dept. of Geriatric medicine, East Hospital, Tongji University School of Medicine, Shanghai 200120, China;Dept. of Endocrinology, Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200333, China)
Abstract:
Objective To investigate the effect of berberine on blood glucose, HOMA-IR, GLP-1 and gut microbiota in patients with newly diagnosed type 2 diabetes mellitus(T2DM). Methods A total of 50 patients with T2DM were randomly divided into berberine group(n=25) and the placebo group(n=25). All the patients received dietary and exercise therapy as well as basic oral hypoglycemic agents. Patients in the berberine group took the berberine 0.5g tid for 12 weeks, patients in the placebo group took the placebo instead. The blood samples were collected to test the levels of FBG, HbA1c, FINS, HOMA-IR, GLP-1 at week 0 and week 12. The fecal samples were cultivated and the levels of gut microbiota were compared between the two groups at week 0 and week 12, including bifidobacteria, lactobacillus, bacteroides, enterobacter and enterococcus. Results The FBG, HbA1c, FINS, HOMA-IR and GLP-1 were significantly improved after intervention in both groups(P<0.05). After intervention, the levels of FBG, HbA1c and HOMA-IR in the berberine group were significantly lower, and levels of GLP-1 were higher than those in placebo group(P<0.05). In berberine group, the intestinal bifidobacteria and lactobacillus significantly increased, while enterococcus, bacteroidetes and enterobacter decreased compared with the placebo group(P<0.05). The levels of bifidobacteria and lactobacillus were negatively correlated with FBG, while the enterobacter was positively correlated with FBG(P<0.05). Conclusion Berberine can play a role in reducing the blood glucose, improving the insulin resistance as well as regulating gut microbiota and GLP-1.
Key words:  berberine  type 2 diabetes mellitus  gut microbiota  glucagon-like peptide-1  blood glucose

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