2型糖尿病患者短期胰岛素强化治疗前后血清nesfatin-1水平的变化
投稿时间:2014-10-12  修订日期:2014-10-22  点此下载全文
引用本文:高辽梅,张勇,王东,侯艳丽,刘昱青,纪锴,季虹,荣海钦.2型糖尿病患者短期胰岛素强化治疗前后血清nesfatin-1水平的变化[J].医学研究杂志,2015,44(5):114-117
DOI: 10.11969/j.issn.1673-548X.2015.05.031
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作者单位E-mail
高辽梅 250062 济南大学-山东省医学科学院医学与生命科学院  
张勇 250062 济南, 山东省内分泌与代谢病研究所  
王东 250062 济南, 山东省内分泌与代谢病研究所  
侯艳丽 250062 济南, 山东省内分泌与代谢病研究所  
刘昱青 250062 济南大学-山东省医学科学院医学与生命科学院  
纪锴 250062 济南大学-山东省医学科学院医学与生命科学院  
季虹 250062 济南, 山东省内分泌与代谢病研究所  
荣海钦 250062 济南, 山东省内分泌与代谢病研究所 13864128999@139.com 
中文摘要:目的 观察2型糖尿病患者短期胰岛素强化治疗前后血清nesfatin-1水平的变化,分析血清nesfatin-1水平与血糖、血脂及糖尿病相关肥胖的关系。方法 60例(年龄40~60岁、病程≤5年)血糖控制不佳(HbA1c≥7%)的2型糖尿病患者按体重指数(BMI)分为糖尿病体重正常组(T2DM-NW组,30例,BMI<24kg/m2)和糖尿病肥胖组(T2DM-OB组,30例,BMI≥28kg/m2),进行为期2周的胰岛素强化降糖治疗。比较两组之间及治疗前后空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、血脂、稳态模型评估的胰岛β细胞功能指数(HOMA-β)和胰岛素抵抗指数(HOMA-IR)、血清nesfatin-1水平的变化及相互关系。结果 胰岛素强化治疗前T2DM-NW组血清nesfatin-1水平显著高于T2DM-OB组(P<0.05);胰岛素强化治疗后, 两组FPG、2hPG、HbA1c、TG、TC、LDL-C、HOMA-IR、血清nesfatin-1水平较治疗前均显著降低(P<0.05),体重、BMI、FIN、HOMA-β较治疗前均升高(P<0.05);Spearman相关分析显示血清nesfatin-1水平与FPG、2hPG呈正相关(r值分别为0.295、0.257,P均<0.05),而与体重、BMI、TG、TC呈显著负相关(r值分别为-0.641、-0.770、-0.507、-0.543,P均<0.05);多元线性回归分析显示BMI为血清nesfatin-1水平的独立影响因素(P<0.01)。结论 胰岛素强化治疗能显著降低2型糖尿病患者血清nesfatin-1水平,摄食抑制脂肪因子nesfatin-1与血糖、血脂、糖尿病相关性肥胖有密切关联。
中文关键词:糖尿病2型  肥胖  Nesfatin-l  胰岛素强化治疗
 
Changes of Serum Nesfatin-1 Level in Type 2 Diabetic Patients by Short-term Intensive Insulin Treatment
Abstract:Objective To explore the changes of the serum nesfatin-1 level of type 2 diabetes mellitus (T2DM) patients by short-term intensive insulin treatment, and analyze its relationship with blood glucose, blood lipid, obesity related T2DM. Methods According to the BMI, 60 T2DM patients (aged 40-60years old, diagnosed ≤5years) with blood glucose uncontrolled(HbA1c≥7%),were divided into two groups: T2DM with normal body weight (T2DM-NW group, n=30,BMI<24kg/m2) and T2DM with obesity (T2DM-OB group, n=30,BMI≥28kg/m2).All subjects accepted two-week intensive insulin therapy. The change and relationship of fasting blood glucose (FPG),2-hour postprandial blood glucose (2hPG), HbA1c, triglyceride (TG), total cholesterol (TC), homa beta cell function index (HOMA-β),insulin resistance index (HOMA-IR) and the serum nesfatin-1 before and after treatment between two groups were Compared and analyzed. Results The results showed that the serum nesfatin-1 level in T2DM-NW group was significantly higher than that in T2DM-OB group(P<0.05) pre-treatment.After treatment, the FPG, 2hPG, HbA1c, TC, TG,LDL-C, HOMA-IR and serum nesfatin-1 levels of both two groups were decreased dramatically,but body weight, BMI, FIN, HOMA-β were increased(P<0.05).Pearson correlation analysis showed that the level of serum nesfatin-1 was positively correlated with FPG,2hPG(r value were 0.295, 0.257, P<0.05),while negatively correlated with body weight, BMI, TG, TC(r value were -0.641, -0.770,-0.507,-0.543,P<0.05);Multiple stepwise linear regression analysis showed that BMI was independently associated with serum nesfatin-1 level (P<0.01). Conclusion The serum nesfatin-1 level can be decreased significantly by short-term intensive insulin treatment. These results suggest that nesfatin-1 may have closely relationship with blood glucose, blood lipid, obesity related T2DM.
keywords:Type 2 diabetes mellitus  Obesity  Nesfatin-1  Intensive insulin therapy
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