地特胰岛素联合罗格列酮对2型糖尿病患者体重指数和血清脂肪细胞因子的影响

目的探讨地特胰岛素联合罗格列酮对2型糖尿病患者体重指数和血清脂肪细胞因子的影响。方法选取初诊2型糖尿病患者48例,随机分为地特胰岛素组(n=24)和中性鱼精蛋白锌胰岛素(NPH)组(n=24),分别用地特胰岛素和中性鱼精蛋白锌胰岛素联合罗格列酮治疗,疗程12周。比较治疗前后两组体重指数、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、瘦素、抵抗素和脂联素水平变化。结果治疗后,地特胰岛素组BMI较治疗前降低,但差异无显著性(P>0.05);NPH组BMI较治疗前显著升高,差异具有显著性(P<0.05)。地特胰岛素组、NPH组FPG、HbA1c、FINS、瘦素和抵抗素水平均较治疗前显著下降(P<0.05),其中地特胰岛素组瘦素和抵抗素下降较NPH组明显,差异具有显著性(P<0.05)。地特胰岛素组、NPH组脂联素水平均较治疗前明显升高,其中地特胰岛素组脂联素水平较NPH组升高明显,差异具有显著性(P<0.05)。结论地特胰岛素联合罗格列酮治疗可以避免罗格列酮增加体重的副作用发生,并能增强罗格列酮降瘦素、抵抗素和升高脂联素的作用。

The effects of insulin detemir and Rosiglitazone on Body Mass Index and serum adipocytokines in patients with type 2 diabetes mellitus

Objective To study the effects of insulin detemir combined with Rosiglitazone on body mass index and serum adipocytokines in patients with type 2 diabetes mellitus.Methods 48 patients newly diagnosed with type 2 diabetes mellitus were randomly divided into insulin detemir group(n=24) and neutral protamine hagedorn insulin(NPH) group(n=24),the patients in insulin detemir group were treated with insulin detemir plus Rosiglitazone,and the patients in NPH group were treated with NPH plus rosiglitazone for a course of 12 weeks.Before and after treatment,the levels of body mass index,fasting plasma glucose(FPG),fasting insulin(FINS),glycated hemoglobin(HbA1c),leptin,resistin and adiponectin of patients in two groups were measured and compared.Results After treatment,the BMI in insulin detemir group reduced,compared to pre-treatment,there was not significant difference(P>0.05),while BMI in NPH group elevated significantly(P<0.05).The levels of FPG,FINS,HbA1c,leptin and resistin of patients in two groups reduced significantly(P<0.05),of which levels of leptin and resistin in insulin detemir group decreased more,compared to NPH group,there were significant differences(P<0.05).The levels of adiponectin of patients in two groups elevated significantly(P<0.05).The patients in insulin detemir group had greater increases in levels of adiponectin than those in NPH group(P<0.05).Conclusion Insulin detemir combined with Rosiglitazone in treatment of type 2 diabetes mellitus can avoid the side effect of weight gain induced by Rosiglitazone,can also enhance the effects of rosiglitazone on reducing leptin and resistin and elevating adiponectin.