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1.
目的 探讨短期胰岛素泵强化治疗对初诊2型糖尿病(T2DM)患者胰岛素敏感性和血浆成纤维细胞生长因子-21(FGF-21)水平的影响.方法 采用自身前后对照,运用高胰岛素-正葡萄糖钳夹术评价30例新诊断T2DM患者接受2 w短期胰岛素泵 (CSII) 强化治疗前后胰岛素敏感性的变化,并采用酶免法测定治疗前后血浆FGF-21水平.结果 T2DM患者血浆FGF-21水平明显高于对照组[(1.6±0.1) vs (1.1±0.4) μg/L,P<0.01].T2DM患者经胰岛素泵强化治疗2 w后,血浆FGF-21水平较治疗前明显下降[(1.6± 0.1) vs (1.3 ± 0.1) μg/L,P<0.05].多元逐步回归分析表明,WHR、2 h PBG、SBP及FFA是影响血浆FGF-21水平的独立相关因素(YFGF-21=0.625XWHR+0.034XPBG+0.003XSBP-0.419XFFA+0.626).结论 短期胰岛素泵强化治疗可明显降低T2DM患者血浆FGF-21水平,血浆FGF-21水平与代谢紊乱有关,并可能参与了T2DM的发生和发展.  相似文献   

2.
目的分析腹部皮下注射重组促胰岛素分泌素(E-4)对2型糖尿病(T2DM)患者成纤维细胞生长因子21(FGF-21)水平的影响。方法选取2010年10月—2013年10月浚县人民医院内科收治的T2DM患者85例,将其随机分为对照组42例和试验组43例。对照组腹部皮下注射0.9%氯化钠溶液150μl,试验组腹部皮下注射E-45μg/150μl,均连续注射12周。比较两组患者治疗前后空腹血糖(FBG)、餐后2 h血糖(2 hPBG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-IS)及血浆FGF-21水平。结果治疗前两组患者FBG、2 hPBG、HbA1c、HOMA-IR、HOMA-IS及FGF-21水平比较,差异均无统计学意义(P0.05);治疗后试验组患者FBG、2 hPBG、HbA1c、HOMA-IR及FGF-21水平低于对照组,HOMA-IS高于对照组(P0.05)。结论腹部皮下注射E-4能够长期改善T2DM患者糖代谢,降低HOMA-IR和血浆FGF-21水平,提高HOMA-IS。  相似文献   

3.
目的 探讨内脂素基因过表达对大鼠胰岛素敏感性和血浆成纤维细胞生长因子21(FGF-21)的影响.方法 构建大鼠内脂素基因重组真核表达质粒,将该质粒转染大鼠.在转染前后采用正糖-高胰岛素钳夹技术评价大鼠胰岛素敏感性变化,并采用放射免疫法测定其血浆FGF-21浓度.结果 在质粒注射后3 d大鼠血清内脂素水平明显升高(1.49±0.06 vs 0.99±0.04,P<0.01);葡萄糖输注率(GIR)[(35.3±1.4 vs 27.6±1.7)mg·kg-1·min-1,P<0.01]较注射前明显升高;基础血浆胰岛素水平明显下降[(14.5±3.7 vs 24.4±6.2)mU/L,P<0.05];总胆固醇、高密度脂蛋白胆固醇明显降低[(1.31±0.10 vs1.76±0.22)mmol/L和(0.59±0.04 vs 0.95±0.15)mmol/L,均P<0.05];血浆FGF-21也降低[(2.25±0.19 vs 2.59±0.23) μg/L,P<0.05];在转染前后基础血糖和血浆脂联素水平无明显变化.结论 内脂素质粒转染使大鼠血浆vsfatin水平升高和FGF-21水平降低,胰岛素敏感性增强.  相似文献   

4.
目的 探讨初诊2型糖尿病(T2DM)及酮症(T2DK)患者血浆丝氨酸蛋白酶抵制剂(Vaspin)水平变化与BMI、血脂、血糖、胰岛素抵抗指数(HOMA-IR)等的关系.方法 采用ELISA法测定28例T2DM患者、32例T2DK患者及25例正常人(NC组)血浆Vaspin水平,分析血浆Vaspin水平与BMI、血脂、血糖和HOMA-IR等的关系.结果 T2DM组血浆Vaspin水平明显高于NC组[(0.71±0.18 )μg/L vs (0.52±0.13 )μg/L,P<0.05],T2DK组又明显高于T2DM组[(1.95±0.21)μg/L vs (0.71±0.18)μg/L,P<0.01].空腹血浆Vaspin水平分别与BMI、三酰甘油(TG)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)和HOMA-IR呈明显正相关(P<0.05),与Fins和胰岛素分泌指数(HOMA-IS)呈明显负相关(P<0.05).BMI、FPG和HOMA-IR是影响血浆Vaspin水平的独立相关因素.结论 血浆Vaspin水平的改变与糖脂代谢紊乱和胰岛素抵抗有关,并可能参与了T2DM及T2DK的发生和发展.  相似文献   

5.
目的 探讨T2DM患者血浆网膜素水平的变化及利拉鲁肽治疗对网膜素水平的影响.方法 采用酶联免疫法测定T2DM患者及正常人血浆网膜素水平,分析血浆网膜素水平与BMI、WHR、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞分泌指数(HOMA-IS)、FFA等的关系,观察利拉鲁肽治疗前后T2DM患者血浆网膜素水平的变化. 结果 T2DM患者血浆网膜素水平明显低于正常人[(19.3±3.9)vs(26.4±6.0) μg/L,P<0.01].T2DM患者血浆网膜素水平与FIns、HOMA-IR呈负相关(r=-0.41,P<0.05和r=-0.56,P<0.01).T2DM患者经利拉鲁肽治疗后WHR、BMI、FPG、2hPG和HbA1c均显著降低(P均<0.01),而HOMA-IS则显著增高(P<0.01),空腹血浆网膜素水平也显著增高[(19.3±3.9)vs(21.2±3.8)μg/L,P<0.01]. 结论 利拉鲁肽能有效改善T2DM患者糖代谢和IS,同时升高血浆网膜素水平.  相似文献   

6.
目的探讨罗格列酮对T2DM患者血浆内脏脂肪特异性丝氨酸蛋白酶抑制剂(vaspin)水平的影响。方法将105例研究对象分为NGT、IGR和T2DM组。T2DM组用罗格列酮治疗12周。检测人体测量参数和生化指标,采用稳态模型评估胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能指数(HOMA-IS),用ELISA测定血浆vaspin浓度。分析vaspin浓度及各参数间的关系及罗格列酮治疗前后vaspin浓度的变化。结果 T2DM组空腹血浆vaspin水平(1.19±0.74)μg/L高于NGT组(0.54±0.28)μg/L和IGR组(0.46±0.26)μg/L(P<0.05),NGT组和IGR组间差异无统计学意义。血浆vaspin水平与FIns和HOMA-IR呈正相关。罗格列酮治疗12周后,T2DM组空腹血浆vaspin水平明显下降[(1.19±0.74)μg/L vs(0.91±0.54)μg/L,P<0.05]。结论 T2DM组血浆vaspin水平增高,罗格列酮治疗在控制血糖及改善IS同时,降低了血浆vaspin水平。  相似文献   

7.
目的探讨新诊断T2DM患者成纤维细胞生长因子21(FGF-21)与血管内皮功能的相关性。方法选取2015年6月至2017年4月于我院内分泌科门诊治疗的新诊断T2DM患者(T2DM组)95例,另选取同期我院健康体检人群50名为正常对照(NC)组。测定临床生化指标及血清FGF-21水平,采用反应性充血指数(RHI)评价血管内皮功能。结果 T2DM组FGF-21高于NC组[(190.8±96.4)vs(117.4±68.9)ng/ml,P0.05],RHI低于NC组[(1.71±0.42)vs(2.05±0.52),P0.05]。Pearson相关分析显示,RHI与FGF-21、TC、LDL-C、SBP、DBP呈负相关(r=-0.270、-0.217、-0.249、-0.251、-0.227,P0.05)。多元线性回归分析显示,FGF-21、LDL-C是新诊断T2DM患者RHI的影响因素。结论新诊断T2DM患者血清FGF-21升高可能是血管内皮功能异常引起代偿性分泌所致。  相似文献   

8.
目的探讨谷胱甘肽系统对2型糖尿病(T2DM)患者冠状动脉病变程度的影响。方法选取行冠状动脉造影术的患者236例,分为正常糖耐量(NGT)组126例,T2DM组110例,检测患者的血液生化指标以及还原型谷胱甘肽(GSH)、GSH过氧化物酶(GSH-Px)和谷胱甘肽还原酶(GR)的活性。根据冠状动脉造影结果,采用Gensini评分系统对每支血管病变程度进行定量评分。结果 T2DM组血浆GSH[(3.87±1.55)μg/L vs(4.45±1.94)μg/L]、GSH-Px[(0.29±0.05)ng/L vs(0.35±0.08)ng/L]和GR[(0.19±0.07)ng/L vs(0.26±0.08)ng/L]活性明显低于NGT组,差异有统计学意义(P<0.05)。校正年龄、体重指数、血压、血脂、空腹血糖、空腹胰岛素、餐后2h血糖、餐后2h胰岛素、糖化血红蛋白因素后,T2DM组GSH、GSH-Px、GR活性与Gensini积分呈负相关(P<0.05,P<0.01)。T2DM组GSH、GSH-Px和GR活性对Gensini积分的影响作用最大。结论 T2DM患者血浆GSH、GR和GSH-Px活性的降低与冠状动脉病变程度具有一定的负相关性,且为该人群冠状动脉病变的独立影响因素。  相似文献   

9.
糖尿病一级亲属脂联素和瘦素与胰岛素抵抗的相关性   总被引:8,自引:3,他引:8  
目的 了解2型糖尿病(T2DM)患者一级亲属非糖尿病个体中瘦素、脂联素水平的变化,研究瘦素、脂联素与胰岛素抵抗(IR)的相关性。 方法 选取 153 例糖耐量正常者,其中无家族史的正常对照(NC)者41例,单纯父亲为糖尿病的一级亲属 36 例,单纯母亲为糖尿病的一级亲属 45例,双亲均为糖尿病的一级亲属31例。测定所有受试者血脂、血糖、胰岛素、瘦素、脂联素。 结果 T2DM患者一级亲属中3个亚组瘦素水平[(11±6)μg/L、(10±5)μg/L、(11±9)μg/L]高于 NC组[(8±6)μg/L](P<0 05),胰岛素抵抗指数(IRI)[(3.0±1.4)、(2.9±1.5)、(3 3±1 5)]高于 NC组[(2.0±0.8)](P<0.05),脂联素水平[(11±6)g/L、(10±6)g/L、(12±8) g/L]低于 NC组[(17±11)g/L](P<0.05)。一级亲属各组间的代谢指标差异无统计学意义。体质指数、瘦素、腰围、腰臀比、脂联素是 IRI的独立危险因素。 结论 T2DM患者一级亲属 IR程度显著高于无家族史者。脂联素与瘦素可能联合影响T2DM患者一级亲属的 IR程度。  相似文献   

10.
目的观察老年T2DM大血管病变患者凝血功能的改变和评估血栓弹力图(TEG)在其凝血功能障碍中的作用。方法将60例老年T2DM患者分为单纯T2DM(T2DM组)和T2DM合并大血管病变(T2DM+MVC组),每组各30例;另选健康对照(NC组)组30名。各组均行常规凝血功能和TEG检测。结果常规凝血功能检测显示,与NC组比较,T2DM组[(3.79±0.75)vs(3.36±0.91)g/L]和T2DM+MVC组纤维蛋白原(FIB)[(4.27±1.06)vs(3.36±0.91)g/L]均升高(P<0.05),且T2DM+MVC组高于T2DM组(P<0.05)。TEG检测显示,与NC组比较,T2DM组R值[(6.31±0.94)vs(5.74±0.88)min]缩短(P<0.05);T2DM+MVC组R值[(6.31±0.94)vs(4.76±1.27)min]和K值[(2.31±0.24)vs(1.64±0.62)min]缩短(P<0.01),Angle角[(60.61±4.75)vs(67.40±7.77)deg]变大(P<0.01)。结论老年T2DM大血管病变患者存在凝血功能紊乱。TEG指标可能能反映该类患者的凝血功能障碍。  相似文献   

11.
AIM: Metformin is the 'drug-of-first-choice' in obese patients with type 2 diabetes mellitus (T2DM) due to its antihyperglycaemic and cardiovascular protective potentials. In non-obese patients with T2DM, insulin secretagogues are empirically used as first choice. In this investigator-initiated trial, we evaluated the effect of metformin vs. an insulin secretagogue, repaglinide on glycaemic regulation and markers of inflammation and insulin sensitivity in non-obese patients with T2DM. METHODS: A single-centre, double-masked, double-dummy, crossover study during 2 x 4 months involved 96 non-obese (body mass index < or = 27 kg/m(2)) insulin-na?ve patients with T2DM. At enrolment, previous oral hypoglycaemic agents (OHA) were stopped and patients entered a 1-month run-in on diet-only treatment. Hereafter, patients were randomized to either repaglinide 2 mg thrice daily followed by metformin 1 g twice daily or vice versa each during 4 months with 1-month washout between interventions. RESULTS: End-of-treatment levels of haemoglobin A(1c) (HbA(1c)), fasting plasma glucose, mean of seven-point home-monitored plasma glucose and fasting levels of high-sensitivity C-reactive protein and adiponectin were not significantly different between treatments. However, body weight, waist circumference, fasting serum levels of insulin and C-peptide were lower and less number of patients experienced hypoglycaemia during treatment with metformin vs. repaglinide. Both drugs were well tolerated. CONCLUSIONS: In non-obese patients with T2DM, overall glycaemic regulation was equivalent with less hypoglycaemia during metformin vs. repaglinide treatment for 2 x 4 months. Metformin was more effective targeting non-glycaemic cardiovascular risk markers related to total and abdominal body fat stores as well as fasting insulinaemia. These findings may suggest the use of metformin as the preferred OHA also in non-obese patients with T2DM.  相似文献   

12.
目的 研究血浆四氢生物蝶呤(tetrahydrobiopterin,BH4)与2型糖尿病大血管并发症的关系.方法 100例T2DM患者分为两组:未合并大血管并发症组41例,合并大血管并发症组59例.并设正常对照25例,检测血浆BH4及其他相关指标.结果 (1)2型糖尿病组BH4水平明显低于对照组(P<0.01);糖尿病合并大血管病变组血浆BH4水平明显低于未合并大血管病变组(P<0.01)和正常对照组(P<0.01);(2)随着HBA1c水平的增高,血浆BH4水平呈下降趋势;(3)回归分析显示BH4水平与TC呈显著负相关(P<0.01),与CRP呈负相关(P<0.05).结论 血浆BH4水平在2型糖尿病患者中明显降低,合并大血管病变者降低更为明显,提示血浆BH4水平降低是2型糖尿病大血管病变的危险因素.  相似文献   

13.
目的 观察麝香保心丸对2型糖尿病(T2DM)合并慢性收缩性心力衰竭患者心功能和血浆脑钠肽(BNP)水平的影响.方法 纳入78例T2DM合并慢性收缩性心力衰竭患者,随机分为常规治疗组(对照组,n=38)和常规治疗+麝香保心丸组(观察组,n=40),治疗6个月后观察临床总有效率,6 min步行试验和血浆BNP浓度以及心功能超声检查各项参数的改善情况.结果 观察组总有效率90.0%,对照组总有效率78.9%,两组比较差异有统计学意义(P<0.05).治疗后两组血浆BNP浓度均值较治疗前均有下降,但观察组下降较对照组更加明显(P<0.05).6 min步行试验运动耐量观察组较对照组增强(P<0.05).两组治疗后心功能各项参数较治疗前均有改善(P<0.05);而治疗后观察组心功能指标改善较对照组更加明显,差异有统计学意义(P<0.05~0.01).结论 麝香保心丸能显著提高T2DM合并慢性收缩性心力衰竭患者的运动耐量,降低血浆BNP浓度,改善心功能.  相似文献   

14.

Objective

Omentin is a protein expressed and secreted from visceral but not subcutaneous adipose tissue, which increases insulin sensitivity in human adipocytes. However, its pathophysiologic role in humans remains largely unknown. The objective of this study is to assess plasma omentin-1 levels in patients with type 2 diabetes mellitus (T2DM) and matched control subjects and to investigate the effects of liraglutide on plasma omentin-1 levels in patients with T2DM.

Patients and methods

Thirty T2DM patients with poor glycemic control after more than 3 months of treatment with one or two OHA(s) (T2DM), and 30 matched normal glycaemic controls (NGT) participated in the study. The T2DM group was given an injection of liraglutide once-daily for 16 weeks. Plasma omentin-1 levels were measured by enzyme-linked immunosorbent assay and the relationship between plasma omentin-1 levels and metabolic parameters was also analyzed.

Results

Plasma omentin-1 levels were lower in T2DM than in the control (19.3 ± 4.0 μg/L vs. 26.4 ± 6.0 μg/L, P < 0.01). Plasma omentin-1 levels increased significantly in T2DM patients after treatment with liraglutide compared with pre-treatment (19.3 ± 4.0 μg/L vs. 21.2 ± 3.9 μg/L, P < 0.01). In all diabetic patients, multiple regression analysis showed that FINS and HOMA-IR were independently associated with plasma omentin-1 levels.

Conclusions

In T2DM patients, plasma omentin-1 levels decreased, but significantly increased after the treatment with liraglutide and metformin. These data suggest that liraglutide may play a role in increasing omentin-1 levels in T2DM patients.  相似文献   

15.
目的 本研究探讨2型糖尿病(T2DM)患者血浆成纤维细胞生长因子21(FGF-21)水平变化及其与体质指数(BMI)、血糖、血浆胰岛素水平等因素的关系.方法 选取2013年1月至7月于首都医科大学附属北京朝阳医院内分泌科就诊患者180例为研究对象,分为新诊断T2DM组(DM组,136例),糖耐量受损组(IGR组,44例),另选取同期体检健康志愿者52名为对照组(NDM组),应用ELISA方法测定了上述人群的血浆FGF-21水平,并分析血浆FGF21水平与BMI、血糖、血脂、血浆胰岛素、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(HOMA-ISI)等的关系.组间比较采用独立样本t检验进行统计学分析.采用Pearson法进行相关性分析,相关因素分析采用多元线性回归分析法.结果 初诊T2DM患者血浆FGF21水平明显高于健康对照组(319.2±2.5比223.1± 1.4,t=2.804,P<0.05).初诊T2DM患者、健康对照组血浆FGF-21水平均与TG水平呈正相关(r=0.26、0.38,均P<0.05);在IGR组,血浆FGF-21水平与BMI呈正相关(r=0.33,P<0.05).多元回归分析表明HOMA-ISI是影响T2DM患者血浆FGF21水平的独立相关因素.结论 初发2型糖尿病患者血浆FGF21水平的改变与甘油三酯水平及胰岛素抵抗有关.  相似文献   

16.
AimTo investigate whether vildagliptin, one of the dipeptidylpeptide-4 (DDP-4) inhibitors, improves not only glycemic control but also glycemic fluctuation when added to ongoing sulfonylurea (SU) based oral hypoglycemic agents (OHA) therapy in patients with type 2 diabetes mellitus (T2DM).MethodsA total of 19 patients with T2DM were recruited from outpatients. Vildagliptin was initiated with a dose of 100 mg per day in the patients who had inadequate glycemic control and glycemic fluctuation with ongoing SU based OHA therapy. Glycemic excursion was defined by seven-point self-monitoring blood glucose (SMBG) on three days at baseline and 12 weeks after vildagliptin-combined therapy, as well as HbA1c levels. M-value and J-index were calculated to evaluate glycemic excursion.ResultsAddition of vildagliptin to ongoing SU based OHA therapy significantly decreased HbA1c values from 8.2 ± 3.8% at baseline to 7.3 ± 0.8% at 12-week. The average of blood glucose profiles was significant improved. As a result, M-value was significantly corrected from 20.9 ± 14.4 to 12.2 ± 13.5 and J-index from 55.1 ± 25.5 to 39.1 ± 19.8.ConclusionsVildagliptin when added to ongoing SU based OHA therapy for 12 weeks significantly improved glycemic fluctuation as well as glycemic control in Japanese patients with T2DM.  相似文献   

17.
目的比较胰岛素(Ins)与口服降糖药(OHA)治疗对新诊断2型糖尿病(T2DM)患者胰岛β细胞功能的影响。方法64例新诊断T2DM患者随机分为Ins组和OHA治疗组。定期检测PG、Ins、C-P水平及其他相关指标,用HOMA-β、HOMA-IR及△I30/△G30来评价胰岛功能变化。结果(1)随访至6个月时,两组上述指标均元统计学差异(P均〉0.05)。(2)随访至12个月时,与OHA组比,Ins组HOMA-β及△I30/△G30较治疗前显著上升(P〈0.05)。两组HOMA-IR无统计学差异(P〉0.05)。结论与0HA相比,早期Ins治疗能更好地保护B细胞功能。  相似文献   

18.
目的探讨Apelin-12与高血压、肥胖、胰岛素抵抗、炎症等的相关性。方法测定31例单纯2型糖尿病、37例2型糖尿病合并高血压患者及25例健康对照者血浆Apelin-12、肿瘤坏死因子α(TNF-α)、血脂、糖化血红蛋白(HbA1c)、空腹血糖、空腹胰岛素(FINS)、胰岛素抵抗(IR)指数(HOMA-IR)、体重指数(BMI)、血压等水平并进行各参数之间的相关分析。结果①糖尿病合并高血压组血浆Apelin-12水平低于正常对照组和单纯糖尿病组(P0.05或P0.01),单纯糖尿病组血浆Apelin-12水平高于正常对照组(P0.05)。②糖尿病合并高血压组TNF-α水平高于糖尿病组和正常对照组(P0.05或P0.01),糖尿病组TNF-α水平高于正常对照组(P0.05)③直线相关分析显示,空腹血浆Apelin-12与腰臀比(WHR),FINS,HOMA-IR,甘油三酯(TG),收缩压(SBP),TNF-α呈负相关,与HDL-C呈正相关。结论血浆Apelin-12水平在糖尿病组升高,在糖尿病合并高血压组降低,且与肥胖、IR、炎症等相关。推测Apelin-12可能参与了IR、2型糖尿病、高血压等疾病的发生发展。  相似文献   

19.
AimsContinuous intraperitoneal insulin infusion (CIPII) is a last-resort treatment option for patients with type 1 diabetes mellitus (T1DM) who fail to reach adequate glycaemic control with subcutaneous (SC) insulin therapy. Aim was to compare the long-term effects of CIPII and SC insulin therapy among patients with T1DM in poor glycaemic control.MethodsPatients in which CIPII was initiated in 2006 were compared with a control group of T1DM patients who continued SC therapy. Linear mixed models were used to calculate differences between the baseline (2006) and final (2013) measurements within and between groups.ResultsA total of 95 patients of which 21 were using CIPII and 74 using SC insulin were included. Within the CIPII group, the number of hypoglycaemic episodes decreased with −5 (95% CI −8 to −3) per 2 weeks while it remained stable among SC patients. Over time, only the number of hypoglycaemic episodes decreased more with CIPII as compared to SC insulin treatment (difference: −6 (95% CI −9 to −4)). There were no differences between treatment groups regarding clinical parameters and quality of life scores over time. Pump or catheter dysfunction led to ketoacidosis in 6 patients: 2 using CIPII and 4 SC insulin.ConclusionsAfter 7 years of follow-up, there is a persistent decline of hypoglycaemic events among CIPII treated T1DM patients. Besides less hypoglycaemic episodes with CIPII therapy, there are no differences between long-term CIPII and SC insulin therapy.  相似文献   

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