胰岛素强化治疗对2型糖尿病患者血浆 GPC-4水平的影响

目的：探讨胰岛素强化治疗对初诊2型糖尿病（T2DM ）患者血浆磷脂酰基醇蛋白聚糖-4（GPC-4）水平的影响及其与胰岛素敏感性的关系。方法随机选择38例初诊 T2DM 患者（T2DM 组），于胰岛素强化治疗前及治疗4周后进行血浆G PC-4水平及其他指标检测，采用高胰岛素-正葡萄糖钳夹术评价患者胰岛素敏感性的变化。以糖耐量正常的体检健康者40例（NGT组）作为对照。结果 T2DM组空腹血浆GPC-4水平为（5．27±1．97）μg/L ，低于NGT 组[（7．33±2．36）μg/L ，P＜0．05）]。胰岛素强化治疗后，T2DM 组空腹血浆 GPC-4水平为（6．42±2．21）μg/L ，较治疗前明显升高（P＜0．05）。治疗后，T2DM 组葡萄糖代谢率明显升高，胰岛素抵抗指数明显降低（P＜0．05），且GPC-4水平升高程度与葡萄糖代谢率升高程度呈正相关。结论胰岛素强化治疗不仅可升高初诊T2DM患者血浆GPC-4水平，而且有助于改善患者的胰岛素敏感性；血浆GPC-4水平可能与患者胰岛素敏感性有关。

Influence of intensive insulin therapy on plasma glypican-4 level in patients with new-onset type 2 diabetes mellitus

Objective To investigate the influence of intensive insulin therapy on plasma level of glypican-4 （GPC-4） in patients with new-onset type 2 diabetes mellitus （T2DM ） ,and its relationship with insulin sensitivity . Methods A total of 38 patients with new-onset T2DM were enrolled as T2DM group .Plasma GPC-4 and other indi-cators were detected before and 4 weeks after intensive insulin therapy .Euglycemic-hyperinsulinemic clamps were performed to evaluate the insulin sensitivity in all patients .A total of 40 healthy subjects with normal glucose toler-ance （NGT） were enrolled as controls （NGT group） .Results Fasting plasma GPC-4 level was （5 .27 ± 1 .97）μg/L in T2DM group ,which was lower than the （7 .33 ± 2 .36）μg/L in NGT group （P〈0 .05） .Intensive insulin therapy could significantly increase plasma GPC-4 level in T2DM group to （6 .42 ± 2 .21）μg/L （P〈0 .05） ,accompany with increased glucose metabolic rate and decreased insulin resistance index （P〈0 .05） .The elevated plasma GPC-4 level was correlated positively with changes of glucose metabolic rate .Conclusion Intensive insulin therapy could elevate the plasma GPC-4 level and improve insulin sensitivity in patient with new-onset T2DM .GPC-4 might be associated w ith insulin sensitivity in T 2DM patients .