目的 探讨左卡尼汀辅助治疗糖尿病的疗效,为糖尿病的临床治疗提供新的思路。方法 160例糖尿病患者随机分为对照组和治疗组,各80例,对照组给予常规治疗,治疗组在此基础上增加左卡尼汀口服溶液10 mL/次,2次/ d,连续治疗4周为1疗程,2个疗程后比较各组治疗前后血糖、血脂、卡尼汀群、糖化血红蛋白(HbA1c)和胰岛β细胞功能的变化。结果 治疗后,两组的空腹血糖(FPG)、总胆固醇(TC)、高密度脂蛋白(HDL)指标较治疗前均显著下降(P < 0.05);治疗组的三酰甘油(TG)、TC、HDL和低密度脂蛋白(LDL)指标与对照组比较显著改善,且差异具有统计学意义(P < 0.05)。两组的乙酰卡尼汀(ALC)水平较治疗前均显著改善且差异具有统计学意义(P < 0.05);治疗组的左卡尼汀较治疗前明显提高(P < 0.05),与对照组治疗后比较也显著提高,且差异具有统计学意义(P < 0.05)。两组的胰岛素分泌指数(HOMA-B)、胰岛素抵抗指数(HOMA-IR)、空腹胰岛素(FINS)、1hINs/FINS、HbA1c与治疗前相比差异具有统计学意义(P < 0.05);其中HOMA-B、HOMA-IR、HbA1c与对照组比较显著改善(P < 0.05);治疗组的FINS低于对照组,但差异并无统计学意义。胰岛素敏感指数(ISI)治疗前后及两组间差异均无统计学意义。结论 糖尿病患者体内存在左卡尼汀水平的降低,外源性补充左卡尼汀能够在一定程度上纠正糖尿病患者的能量代谢紊乱,对纠正其胰岛素抵抗也具有良好效果。

Objective To investigate the efficacy of levocarnitine in the auxiliary treatment of diabetes, in order to provide new ideas for clinical treatment of diabetes. Methods Diabetic patients (160 cases) were randomly divided into control and treatment groups, and each group had 80 cases. The patients in control group were treated with conventional therapy. The patients in the treatment group were given Levocarnitine Oral Solution on the basis of control group, 10 mL/time, twice daily. For treatment of 4 weeks as a course. One course of treatment was 4 weeks. After two courses, blood sugar, blood lipid, carnitine group, hemoglobin A1c (HbA1c) and β-cell function of insulin between two groups before and after treatment were compared. Results After treatment, fasting plasma glucose (FPG), total cholesterol (TC), high-density lipoprotein (HDL) levels of two groups were lower than those of before treatment significantly (P < 0.05). Triglyceride (TG), TC, HDL, and low density lipoprotein (LDL) were improved significantly compared with those of control group, and the difference was significant (P < 0.05). Acetyl-L-carnitine (AC) levels of two groups were improved compared with those of before treatment with significant difference (P < 0.05). Levocarnitine of treatment group was improved more than that of before treatment (P < 0.05), and was improved more than that of control group, and the difference was significant (P < 0.05). Homeostasis model assessment-B (HOMA-B), insulin resistance index (HOMA-IR), fasting insulin (FINS), 1hINs/FINS, and HbA1c of two groups had statistically significant difference compared with those of before treatment (P < 0.05). In which, HOMA-B, HOMA-IR, HbA1c were improved significantly compared with those of control group (P < 0.05). FINS of treatment group was lower than that of control group, but there was no significant difference. Insulin sensitive index (ISI) had no significant difference between before and after treatment, and two groups. Conclusion Levocarnitine levels are decreased in patients with diabetes. The supplement of exogenous LC can correct the disorder of lipid metabolism in diabetic patients, but also has good effect in correcting the insulin resistance.