·糖尿病的胰岛素治疗·

　　2型糖尿病患者应用甘精胰岛素治疗前后内脏脂肪素水平的变化

　　高谷 李倩 丁波 袁璐 李惠琴 马建华 齐绍康

　　基金项目：南京市医学科技发展项目(ZKM06036)

　　作者单位：210006南京医科大学附属南京第一医院内分泌科

　　通讯作者：马建华，E-mail:majianhua@china.com

　　【摘要】 目的 探讨应用甘精胰岛素治疗的2型糖尿病患者血浆内脏脂肪素(Visfatin)水平的变化与胰岛素抵抗及血糖的关系。 方法 共32例2型糖尿病患者，比较其治疗前后空腹(FPG)及餐后血糖(2hPG)、甘油三酯(TG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FIns)、胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)、Visfatin等相关指标。同时选择性别、年龄等相匹配的26名健康体检者作为对照组进行比较。 结果 32例糖尿病患者治疗前后的TG、FPG、2hPG、HbA1c、HOMA-IR、HOMA-β差异有统计学意义(P<0.05)，治疗后Visfatin水平降低(P<0.05)，与健康人相比，糖尿病患者Visfatin水平降低(P<0.01);Pearson相关分析显示Visfatin与HbA1c、FIns、HOMA-IR呈正相关 ( r=0.259,P<0.05;r=0.586,P<0.01; r=0.385, P<0.01)。多元线性逐步回归分析表明HOMA-IR是血浆Visfatin的独立相关因素。 结论 2型糖尿病患者血浆Visfatin水平的变化与胰岛素抵抗及平均血糖有关，可能在糖尿病及胰岛素抵抗的发病机制中具有一定的作用。

　　Change of plasma visfatin level after insulin glargine therapy in type 2 diabetic patients

　　GAO Gu, LI Qian,DING Bo, et al. Department of Endocrinology, Nanjing First Hospital Affiliated to Nanjing Medical University,Nanjing 210006,China

　　Corresponding author: MA Jian-hua,E-mail:majianhua@china.com

　　【Abstract】 Objective To explore the relationship of plasma visfatin level with insulin resistance and blood glucose after insulin glargine therapy in type 2 diabetic patients. Methods A total of 32 diabetic patients and 26 healthy controls matched for age and gender were enrolled.Fasting plasma glucose(FPG), postprandial blood sugar (2hPG),triglyceride(TG),glycosylated hemoglobin (HbA1c), fasting insulin(Fins), insulin resistance index (HOMA-IR),insulin secretion index (HOMA-β)and plasma visfatin were measured and analyzed. Results There were significant differences in TG, FPG, 2hPG, HbAlc, HOMA-IR and HOMA -β before therapy versus after therapy(P<0.05), and plasma visfatin level was reduced after therapy(P<0.01). The visfatin level was lower in type 2 diabetic patients than in controls (P< 0.01). Plasma visfatin level was positively correlated with HbAlc,FIns and HOMA-IR (r=0.259,P<0.05;r=0.586,P<0.01; r=0.385,P<0.01). Multiple regression analysis showed that HOMA-IR was an independent related factor for plasma visfatin level. Conclusions Plasma visfatin level of type 2 diabetic patients is related to insulin resistance and average blood glucose,which may contribute to insulin resistance and type 2 diabetes mellitus.

　　【Key words】Insulin glargine; Diabetes mellitus, type 2; Visfatin; Insulin resistance; Blood glucose