短期胰岛素泵强化治疗对初诊2型糖尿病患者血清乳酸脱氢酶的影响

目的:观察初诊2型糖尿病(T2DM)患者血清乳酸脱氢酶(LDH)的水平,及经短期胰岛素泵强化(CSII)治疗后血清LDH的变化,并探讨其变化与胰岛素抵抗的相关性。方法:选取正常糖耐量者(NGT)36例,初诊T2DM患者37例,T2DM组于治疗前后均行口服75 g葡萄糖耐量试验(OGTT),检测各点静脉血浆葡萄糖及胰岛素,并检测血脂、血清LDH等相关代谢指标。结果:①T2DM组血清LDH水平(177.92±43.01)U/L明显高于NGT组(160.97±19.43)U/L,差异有统计学意义(t=2.130,P<0.05)。②T2DM组经CSII强化治疗2周后空腹血糖(FPG)及餐后2 h血糖(2hPG)均明显下降,差异均有统计学意义(P<0.01)。同时稳态模型评估的胰岛素抵抗指数(HOMA-IR)显著下降2.00(1.35～2.61)vs 1.30(0.91～1.80)]。早相胰岛素分泌(△INS30/△G30)及晚相胰岛素分泌(△INS120/△G120)均明显升高(1.11±0.95)vs(2.25±2.14),(1.22±1.14)vs(3.57±3.06)],差异均有统计学意义(P<0.05),血清LDH水平显著下降,差异有统计学意义(t=2.397,P<0.05)。③Pearson相关分析显示,T2DM组血清LDH水平与HO-MA-IR成正相关(r=0.359,P<0.05)。④多元逐步回归分析显示,HOMA-IR是影响血清LDH的独立相关因素。结论:初诊T2DM患者经短期CSII强化治疗后胰岛素抵抗及β细胞功能明显改善,同时血清LDH水平显著下降,血清LDH水平与胰岛素抵抗呈正相关。

Effect of short-term continuous subcutaneous insulin infusion on the level of lactate dehydrogenase in newly diagnosed type 2 diabetic mellitus

Objective: To observe the level of serum lactate dehydrogenase(LDH)and to observe the effect of short-term continuous subcutaneous insulin infusion(CSII) on LDH in newly diagnosed T2DM,and to investigate the association between insulin resistance and LDH.Methods: Thirty-six cases as NGT group and 37 newly diagnosed T2DM patients were involved in this study.The newly diagnosed T2DM patients were treated with CSII for 2 week.Before and after CSII therapy,75 g oral glucose tolerance test(OGTT) were performed.The level of plasma glucose and insulin were examined respectively,serum LDH and other items were also measured.Results: ① Serum LDH levels in the T2DM group(177.9±43.01)U/L were higher than the NGT group(161.7±19.41) U/L(t=2.130,P<0.05).② In the T2DM group,there was a significant decrease in fasting plasma glucose(FPG)and 2 h plasma glucose after glucose overload(2hPG)(P <0.01),a significant decrease in homeostasis model assessment for insulin resistance(HOMA-IR) values 2.00(1.35~2.61)vs 1.30(0.91~1.80) ],△INS30/△G30 and △INS120/△G120 were increased markedly(1.11±0.95) vs(2.25±2.14),(1.22±1.14) vs(3.57±3.06)](P <0.01),serum LDH concentrations were significantly decreased(t=2.397,P<0.05) after CSII treatment for 2 weeks.③ In the T2DM group,serum LDH levels positively correlated with HOMA-IR(r=0.359,P<0.05).④ The multiple regression analysis showed that HOMA-IR was an independent related factor in the influence of the LDH concentrations.Conclusion: In the T2DM group insulin resistance and islet β-cell function were improved and serum LDH concentrations were significantly decreased after two weeks CSII treatment.The levels of LDH were positively associated with insulin resistance.