Effects Of Saxagliptin On The Function Of Hypothalamus-pituitary-adrenal Axis In Patients Suffered From Type 2 Diabetes Mellitus

Objectives: To investigate the effects of Saxagliptin on the function of hypothalamus-pituitary-adrenal axis in patients suffered from type 2 diabetes mellitus.Methods: Patients diagnosed as type 2 diabetes mellitus and healthy populations were screened from our hospital during June 2014 to November 2014. Eligible subjects were screened out according to the select requirement. Patients suffered from type 2 diabetes mellitus randomly received the treatment of Saxagliptin(Saxagliptin group) or other oral hypoglycemic drugs(Non-Saxagliptin group) for 16 weeks. Those subjects without diabetes mellitus were acted as Normal group.(1) The levels of corticotropin releasing hormone(CRH), adrenocorticotropic hormone(ACTH) and cortisol( COR)among three groups were compared before treatment. And the levels of fasting plasma glucose, glycosylated hemoglobin, blood lipids and body weight were measured and compared between Saxagliptin group and Non-Saxagliptin group before treatment.(2) To measure the levels of CRH, ACTH, COR and other indexes among three groups for analysis at the end of 16 weeks. The χ2 test, t text and the multiple factor analysis were used for statistical analysis.Results: 1. Screening 40 subjects for Normal group, 82 patients for treatment group, and finally 119 cases completed the trial:40 cases in Normal group, 40 cases in Saxagliptin group and 39 cases in Non-Saxagliptin group. At the beginning, some indexes matched preferably among three groups, including gender, age and years of education(all P>0.1). There were no statistical differences at the levels of body mass index(BMI), CRH, ACTH and COR between Saxagliptin group and Non-Saxagliptin group. But these indexes in the two groups were significantly higher than those in Normal group.2. Before the treatment, differences with regard to years of education, the levels of CRH, ACTH, COR, fasting plasma glucose, glycosylated hemoglobin, blood lipids and proportions of drugs application between Saxagliptin group and Non-Saxagliptin group were not significant(all P>0.1).3. In Saxagliptin group, the levels of serum CRH, ACTH and COR declined dramatically after treatment(15.84±1.72 vs 11.32±2.62;272.57±21.30 vs 217.25±24.34;195.34±14.44 vs 139.88±20.92,all P<0.05). However, no distinct changes were observed at the levels of CRH, ACTH and COR both in Non-Saxagliptin group and Normal group after 16 weeks.4. The levels of fasting plasma glucose, glycosylated hemoglobin, cholesterol and low density lipoprotein were significantly decreased at the end of this trail compared to corresponding indexes at baseline both in Saxagliptin group and Non-Saxagliptin group. The body weight, Waist circumference,BMI, triglycerides and high density lipoprotein had no changes before and after treatment in both groups. In addition,the degree of decline in the levels of the fasting plasma glucose, glycosylated hemoglobin, cholesterol and low density lipoprotein equaled between two groups.5. Multiple factor analysis presented that the decline in the levels of CRH, ACTH and COR was associated with the using of Saxagliptin.Conclusions: Saxagliptin participated in regulating the function of hypothalamus-pituitary-adrenal axis in patients suffered from type 2 diabetes mellitus.