磺脲类降糖药继发性失效2型糖尿病患者血清瘦素水平的变化

目的 观察磺脲类(SU)降糖药继发性失效2型糖尿病(T2DM)患者血清瘦素水平,探讨瘦素水平与其他代谢指标的相关性.方法 选择60例磺脲类降糖药继发性失效T2DM患者(SFS组)、30例血糖控制良好的T2DM患者(WCP组)和20例健康志愿者(NC组).采用酶联免疫吸附法(ELISA法)检测3组受检者的瘦素水平,同时检测生化指标、胰岛素水平等,并进行相关性分析.结果 WCP组患者血清瘦素水平(10.2±3.6)ng/ml]与NC组(6.6±2.3)ng/ml]比较,SFS组患者血清瘦素水平(14.8±3.9)ng/ml]与WCP组比较,差异均有统计学意义(P＜0.05);WCP组及SFS组患者的空腹胰岛素水平分别为(16.5±7.2)μU/L和(17.5±7.5)μU/L]、胰岛素抵抗指数(HOMA-IR)分别为(4.1±2.9)和(4.3±2.9)]与NC组分别为(13.9±6.8)μU/L和(2.7±1.6)]比较,差异均有统计学意义(P＜0.05).相关性分析显示,SFS组患者血清瘦素水平与空腹血糖、餐后2 h血糖、糖化血红蛋白、体质指数、空腹胰岛素、HOMA-IR、三酰甘油及低密度脂蛋白胆固醇水平呈正相关(P＜0.05),与高密度脂蛋白胆固醇水平呈负相关(P＜0.05).结论 瘦素和胰岛素抵抗相互作用,可能在磺脲类降糖药继发性失效发病中起重要作用.

Change of Serum Leptin Level in Type 2 Diabetics with Secondary Failure to Sulfonylureas

Objective To investigate the change of serum leptin (LEP) level in type 2 diabetes mellitus (T2DM) patients with secondary failure to sulfonylureas (SFS),and to study the correlativity of the LEP with other metabolic indexes.Methods Sixty T2DM patients with SFS (SFS group) were enrolled,with thirty T2DM patients with good control of blood glucose as WCP group,and twenty health volunteers as NC group.ELISA assay was applied to measure serum LEP level in all subjects,and some biochemical indexes and insulin level were also measured.The correlation analysis was conducted for the results.Results The LEP level in WCP group(10.2±3.6)ng/ml]was significantly higher than that in NC group(6.6±2.3)ng/ml] (P＜0.05),and significantly lower than that in SFS group (14.8±3.9)ng/ml] (P＜0.05).The fasting insulin (FINS)levels in WCP and SFS groups were respectively (16.5±7.2)μU/L and (17.5±7.5)μU/L,higher than (13.9±6.8)μU/L in NC group (P＜0.05).The Homa insulin resistance index (Homa-IR) in WCP and SFS groups were respectively (4.1±2.9) and (4.3±2.9),higher that (2.7±1.6) in NC group (P＜0.05).The correlation analysis showed that SFS patients′ LEP level was positively correlated with fasting blood glucose,2-hour postprandial blood glucose,glycosylated hemoglobin,body mass index,triglyceride,and lower density lipoprotein-cholesterol (P＜0.05); but negatively with high density lipoprotein-cholesterol (P＜0.05).Conclusion The interaction of serum LEP and insulin resistance might play an important role in development of secondary failure to sulfonylureas.