罗格列酮对非肥胖2型糖尿病患者血清视黄醛结合蛋白4浓度的影响

目的测定非肥胖2型糖尿病（T2DM）患者血清视黄醛结合蛋白4（RBP-4）浓度,同时观察罗格列酮（RSG）对血清RBP-4的影响。方法17例磺脲类降糖药治疗无效的非肥胖T2DM患者（DM组）加用RSG（4mg/d）治疗12周,治疗前后测定血游离脂肪酸、高敏C反应蛋白、HbA1c及腹部脂肪分布。正常对照（NC）组（23例）与DM组性别、年龄及BMI相匹配。两组均测定血清RBP-4、血糖、血脂及胰岛素水平。结果（1）DM组RBP-4水平明显高于NC组（P〈0.01）;DM组治疗前后RBP-4水平无统计学差异（P〉0.05）。（2）多元回归发现,TG（P=0.021）、2hPG（P=0.013）是血清RBP-4的独立影响因子。结论（1）非肥胖2型糖尿病患者血清RBP-4明显增多,且高水平RBP-4与机体糖脂代谢紊乱关系密切。（2）短期RSG治疗未明显降低非肥胖2型糖尿病患者血清RBP-4水平。

The effects of rosiglitazone treatment on the level of serum RBP-4 in non-obese patients with type 2 diabetes

Objective To determine the effects of rosiglitazone treatment on the serum level of retinol binding protein 4（RBP-4）in the non-obese patients with type 2 diabetes.Methods 17 non-obese patients with type 2 diabetes whose diabetes was poorly controlled by sulfonylureas were treated with rosiglitazone（4mg/d）for 12 weeks.23 sex-,age-and BMI-matched non-diabetic subjects were studied as control.We determinded serum levels of RBP-4,glucose,lipid and insulin in all subjects of the two groups.And levels of free fatty acid,high sensitive C-reactive protein and glycosylated hemoglobin,as well as visceral fat area were detected before and after treatment with rosiglitazone in diabetic group.Results 1.Serum RBP-4 was higher in diabetic group than in control group（P〈0.01）,but there was no significant difference in serum RBP-4 between pre-and post-treatment with rosiglitazone in diabetic group（P〉0.05）.2.In a multiple stepwise regression analysis,triglyceride（P=0.021）and 2-hour postprandial glucose（P=0.013）were independent variables of RBP-4.Conclusions 1.The serum level of RBP-4 is higher in the type 2 diabetes,and it is significantly related with some factors of the metabolic disorder.2.The short-term treatment with rosiglitazone can not reduce the serum concentration of RBP-4 in the non-obese patients with type 2 diabetes.