2型糖尿病多种脂肪细胞因子水平及罗格列酮干预治疗的影响

目的:观察罗格列酮治疗2型糖尿病对多种脂肪细胞因子水平的影响及其与胰岛素抵抗的关系。方法:糖尿病组2型糖尿病病人56例,男性33例,女性23例,年龄(61±s 7)a,随机分为2组。观察组30例,予罗格列酮4 mg·d-1;对照组26例,予二甲双胍和(或)磺酰脲类降糖药,疗程均为2 mo。并设正常组,健康者54例,男性30例,女性24例,年龄(61±8)a。测定治疗前后各组的血压、抵抗素、脂联素、瘦素、血糖、胰岛素抵抗水平。结果:糖尿病组血压、空腹血糖和胰岛素、胰岛素抵抗指数、抵抗素和瘦素水平均高于正常组,脂联素水平低于正常组。治疗后,观察组抵抗素和瘦素分别降低(1．73±0．22)μg·L-1和(1．4±0．4)mg·L-1,血糖、胰岛素抵抗明显改善,与治疗前及对照组相比,差异有非常显著意义(P<0．01);脂联素升高(0．6±0．6)mg·L-1,与对照组升高(0．4±0．3)mg·L-1]无显著差异(P>0．05)。抵抗素与空腹胰岛素、脂联素呈负相关(r=-0．386,r=-0．387),与体重指数、三酰甘油和腰臀比呈正相关(r=0．4,r=0．322,r=0．298)。结论:罗格列酮可改善2型糖尿病病人抵抗素、瘦素、脂联素水平,这些脂肪细胞因子的改变可能与2型糖尿病病人胰岛素抵抗的改善有关。

Levels of adipocytokines in patients with type 2 diabetes and interfering treatment of rosiglitazone

AIM: To investigate the serum levels of adipocytokines before and after the treatment of rosiglitazone, together to study the relationship between serum adipocytokine concentrations with insulin resistance in type 2 diabetes. METHODS: Fifty-six patients (M 33, F 23; age (61±s 7) a) with type 2 diabetes (diabetes group) were divided into 2 groups randomly, including 30 in the trial group treated with rosiglitazone 4 mg·d-1 and the other 26 in the control group with biguanides and/or sulfonylureas; and both for a course of 2 mo. Another 54 healthy ones (M 30, F 24; age (61±8) a) were designed as the normal group. The blood pressure (BP) , fasting blood glucose (FBG) , fasting insulin (FINS) , insulin resistance index (IRI) and serum dipocytokine levels (including resistin, adiponectin, leptin) before and after the treatment of 3 groups were observed. RESULTS: Before the treatment, the levels of BP, FBG, FINS, resistin and leptin in normal group were lower than those in the diabetes group, while the level of adiponectin was higher (P < 0.01). After treatment, the levels of resistin and leptin in trial group decreased (1.73±0.22)μg·L-1 and (1.4±0.4) mg·L-1 respectively, with obvious improvement of the blood glucose and insulin resistance presenting significant differences in comparison with those before the treatment and the control group (P < 0.01) . The levels of adiponectin both increased in trial group ((0.6±0.6) mg·L-1) and control group ((0.4±0.3) mg·L-1) , but with no difference between two groups (P > 0.05) . Resistin was negatively in correlation to FINS, adiponectin (r=- 0.386, r = - 0.387) and positively to body mass index, triglycerides and waist to hip ratio (r = 0.4, r = 0.322, r = 0.298) . CONCLUSION: Rosiglitazone can change the levels of resistin, leptin and adiponectin. All these changes of adipocytokine might be well correlated with the improvment of insulin resistance in type 2 diabetes patients.