二肽基肽酶4抑制剂对尿微量白蛋白影响的研究进展

摘要

Dipeptidyl Peptidase-4 inhibitor (DPP-4 inhibitor),a new kind of oral anti-diabetic medicine,has been widely used for the treatment of type 2 diabetes (T2DM) during the last decades.Recent evidence showed that DPP-4 inhibitor may have renal protective effects beyond glycemic control.Some clinical studies revealed that the reduction of HbA1c by DPP-4 inhibitor was paralleled by an improvement of albuminuria and renal function.Experimental studies indicated that the renal protection mechanism of DPP-4 inhibitor may be involved in its multiple effects including anti-inflammatory,anti-oxidation and improvement of endothelial function.However,the evidence of decreasing albuminuria for DPP-4 inhibitor mainly comes from animal models and some clinical trials with small sample size.More large randomized controlled trials (RCT) will be needed to certify the renal protection effect of DPP-4 inhibitor.In this review,the role of DPP-4 inhibitor on albuminuria will be considered and discussed from both experimental and clinical perspectives.%作为一类新型口服降糖药,二肽基肽酶4(DPP-4)抑制剂已广泛用于T2DM的治疗.近年来研究提示,DPP-4抑制剂可能具有独立于降糖效果以外的肾脏保护作用,部分临床研究显示,DPP-4抑制剂具有降低T2DM患者尿微量白蛋白(UMalb)、延缓肾病进展的效应,基础研究表明其肾脏保护的机制可能涉及抗炎、抗氧化、改善内皮细胞功能等作用.而目前DPP-4抑制剂降低UMalb方面的数据主要来源于动物实验和少量小样本临床观察,因而仍有必要开展更多更严谨的大型随机对照(RCT)研究,验证其肾脏保护作用.本文对DPP-4抑制剂在肾脏保护,尤其是改善UMalb方面的研究进展做一综述.