2型糖尿病患者应用甘精胰岛素治疗前后内脏脂肪素水平的变化

目的探讨应用甘精胰岛素治疗的2型糖尿病患者血浆内脏脂肪素（Visfatin）水平的变化与胰岛素抵抗及血糖的关系。方法共32例2型糖尿病患者，比较其治疗前后空腹（FPG）及餐后血糖（2hPG）、甘油三酯（TG）、糖化血红蛋白（HbA1c）、空腹胰岛素（Fins）、胰岛素抵抗指数（HOMA-IR）、胰岛素分泌指数（HOMA-β）、Visfatin等相关指标。同时选择性别、年龄等相匹配的26名健康体检者作为对照组进行比较。结果32例糖尿病患者治疗前后的TG、FPG、2hPG、HbA]C、HOMA-IR、HOMA-13差异有统计学意义（P〈0．05），治疗后Visfatin水平降低（P〈0．05），与健康人相比，糖尿病患者Visfatin水平降低（Pd0．01）；Pearson相关分析显示Visfatin与HbA1C、Fins、HOMA-IR呈正相关（r=0．259，Pd0．05；r=0．586，P〈0．01；r=0．385，P〈0．01）。多元线性逐步回归分析表明HOMA-IR是血浆Vis—fatin的独立相关因素。结论2型糖尿病患者血浆Visfatin水平的变化与胰岛素抵抗及平均血糖有关，可能在糖尿病及胰岛素抵抗的发病机制中具有一定的作用。

Change of plasma visfatin level after insulin glargine therapy in type 2 diabetic patients

Objective To explore the relationship of plasma visfatin level with insulin resistance and blood glucose after insulin glargine therapy in type 2 diabetic patients. Methods A total of 32 diabetic patients and 26 healthy controls matched for age and gender were enrolled. Fasting plasma glucose（FPG）, postprandial blood sugar （2hPG）, triglyceride （TG）, glycosylated hemoglobin （ HbA1 c）, fasting insulin （Fins）, insulin resistance index （HOMA-IR）,insulin secretion index （HOMA-β）and plasma visfatin were measured and analyzed. Results There were significant differences in TG, FPG, 2hPG, HbAlc, HOMA-IR and HOMA -β before therapy versus after therapy（P〈0.05）, and plasma visfatin level was reduced after therapy（P〈0.01）. The visfatin level was lower in type 2 diabetic patients than in controls （P〈 0. 01）. Plasma visfatin level was positively correlated with HbA1c,FIns and HOMA-IR （r=0. 259, P〈0.05;r=0. 586,P〈0.01; r=0. 385,P〈0. 01）. Multiple regression analysis showed that HOMA-IR was an independent related factor for plasma visfatin level. Conclusions Plasma visfatin level of type 2 diabetic patients is related to insulin resistance and average blood glucose, which may contribute to insulin resistance and type 2 diabetes mellitus.