达格列净辅助治疗妊娠期糖尿病的疗效及对TLR4/NF-κB信号通路的影响

doi:10.3969/j.issn.1006-6233.2025.02.004

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Abstract Objective: To investigate the effects of dagliprazin adjuvant therapy on blood glucose level, islet function and toll-like receptor-4 (TLR4)/nuclear factor κB (NF-κB) signaling pathway in patients with gestational diabetes mellitus (GDM). Methods: A total of 126 GDM patients visited the hospital from May 2021 to February 2023 were randomized 1∶1 to metformin treatment (control group) or dagliprazin + metformin (study group). Blood glucose, glycated hemoglobin (HbA1c), islet function index and oxygen-inflammation index including malondialdehyde (MDA), interleukin-12 (IL-12), superoxide dismutase (SOD), tumor necrosis factor-α (TNF-α), disease-related indicators including urinary microprotein (mA1b), uric acid (UA), total bilirubin (TBIL), TLR4/NF-κB signaling pathway related factors including TLR4, intracellular inhibitory protein κB (IκB), NF-κB mRNA were compared between the two groups before treatment and 4 weeks after treatment. The outcome and safety of the two groups were assessed. Results: The levels of FPG [(4.21±0.53) mmol/L VS (5.87±0.86) mmol/L], 2hPG [(5.17±1.02) mmol/L VS (7.98±1.26) mmoL/L], and HbA1c [(4.33±0.76)% VS (5.86±1.02)%] in the study group after treatment were lower than those in the control group (P<0.05). After treatment, the FINS level [(60.35±7.63) mIU/L VS (72.94±8.52) mIU/L] and HOMA-IR [(1.28±0.35) VS (1.94±0.41)] in the study group were lower than those in the control group, while the HOMA-β [(50.49±4.58) VS (42.83±3.95)] was higher than that in the control group (P<0.05). After treatment, the levels of serum MDA, IL-12, and TNF-α in the study group were lower than those in the control group, while the level of SOD was higher than that in the control group (P<0.05). After treatment, the levels of mA1b and UA in the study group were lower than those in the control group, while the level of TBIL was higher than that in the control group (P<0.05). After treatment, the mRNA levels of TLR4 [(0.37±0.10) VS (0.95±0.31)] and NF-κB [(0.40±0.12) VS (0.91±0.30)] in the study group were lower than those in the control group, while the mRNA level of IκB [(1.73±0.33) VS (1.18±0.31)] was higher than that in the control group (P<0.05). The incidence of adverse maternal and infant outcomes in the study group was lower than that in the control group [4.76% vs 15.87%] (P<0.05). No significant adverse reactions occurred in both groups during the treatment period. Conclusion: Dagliprazin adjuvant therapy in patients with GDM can effectively improve blood glucose and islet function, inhibit oxidation-inflammation response, control disease progression, and improve adverse maternal and infant outcomes, with certain safety, and its therapeutic mechanism may be related to inhibiting the activation of TLR4/NF-κB signaling pathway.

Key words： Gestational diabetes mellitus Dagliprazin Metformin Toll-like receptor-4 Nuclear factor κB

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	LUO Shi
	WU Anqin
	ZHU Ying
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LUO Shi,WU Anqin,ZHU Ying, et al. Efficacy of Dagliprazin Adjuvant Treatment on Gestational Diabetes Mellitus and its Impact on TLR4/NF-κB Signaling Pathway[J]. HeBei Med, 2025, 31(2): 197-203.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.02.004 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I2/197

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