罗格列酮对2型糖尿病患者血清脂联素、内脂素水平的影响

目的 探讨罗格列酮对2型糖尿病（T2DM）患者血清脂联素、内脂素水平的影响.方法 我院初次诊断的T2DM患者共95例,按照随机数字表法随机分为对照组（40例）和治疗组（55例）.对照组接受糖尿病知识教育,进行饮食干预和运动疗法,早晚口服二甲双胍缓释片500 mg,治疗过程中不用影响血糖的其他药物.治疗组在对照组的基础之上,加用罗格列酮4 mg/d.两组疗程均为16周.治疗前、后分别测定患者空腹血糖（FBG）、餐后2h血糖（PBG）、糖化血红蛋白（HbA1C）、空腹胰岛素（FINS）、血清脂联素和内脂素,并计算胰岛素抵抗指数（HOMA-IR）.结果 T2DM患者血清脂联素水平明显降低（7.8±3.2） mg/L vs.（3.2±1.3）mg/L],内脂素水平明显升高（85.6±18.5）μg/Lvs.（127.8±20.1）μg/L]（P＜0.01）.罗格列酮能明显降低T2DM患者FBG、PBG、HbA1C、FINS水平,改善HOMA-IR （P＜0.001）；与对照组相比,治疗组血清脂联素水平明显增高（3.2±0.9）mg/L vs.（7.7±2.1）mg/L],内脂素水平明显降低（125.3±18.8）μg/L vs.（79.3±16.4）μg/L （P＜0.01）].T2DM患者血清脂联素与BMI、FPG、HOMA-IR和内脂素呈负相关（P＜0.01）；内脂素水平与BMI、FPG和HOMA-IR呈正相关（P＜0.01）.结论 罗格列酮可通过调控脂联素和内脂素水平,改善胰岛素的敏感性,降低胰岛素的抵抗性,达到纠正高胰岛素血症、降低血糖水平的目的,值得临床推广应用.

Effects of rogridone on serum levels of adiponectin and visfatin in patients with type 2 diabetes mellitus

Objective To explore the effects of rogridone on serum levels of adiponectin and visfatin in patients with type 2 diabetes mellitus （T2DM）.Methods 95 patients with initial diagnosis of T2DM were randomly divided into two groups.The control group （40 patients） received education on diabetes,dietary intervention,exercise therapy,and oral mefformin sustained release tablets of 500 mg in the morning and at night separately with no other glycemia-effecting drugs,while the study group received rogridone of 4 mg daily in addition to the therapies used in the control group for 16 weeks.FBG,PBG,HbA1C,FINS,serum adiponectin and visfatin,and HOMA-IR were measured.Results Serum adiponectin level decreased sharply and level of visfatin increased significantly in patients with T2DM （7.8 ± 3.2vs.3.2 ± 1.3） mg/L and （85.6 ± 18.5 vs.127.8 ± 20.1）μg/L,P〈0.01].Rogridone reduced levels of FBG,PBG,HbA1C,and FINS and improved HOMA-IR in the patients （P〈0.001）.Serum adiponectin level markedly decreased and visfatin level obviously increased in the study group,as compared with the control group （3.2 ± 0.9 vs.7.7 ± 2.1）mg/L and （125.3 ± 18.8 vs.79.3 ± 16.4） μ g/L,P〈0.01].Serum adponectin was negatively correlated with BMI,FPG,HOMA-IR,and visfatin （P〈0.01）; visfatin level was positively related with BMI,FPG,and HOMA-IR （P〈0.01）.Conclusions Rogridone can improve susceptibility of insulin and reduce insulin resistance to correct hyperinsulinemia and lower levels of blood sugar by regulating the changes in levels of serum adiponectin and visfatin.It is worth popularizing clinically.