糖尿病肥胖、脂代谢异常

　　[摘要] 目的 探讨T2DM肥胖患者血浆中葡萄糖转运蛋白(GLUT)的表达与ERK的关系。 方法 将研究对象分为T2DM合并超重/肥胖(T2DM+OB+OW)组、单纯T2DM(T2DM)组、糖调节正常合并超重/肥胖(OB+OW)组及正常对照(NC)组。采用全自动生化分析仪测定血糖浓度;ELISA法检测血胰岛素含量;比色法检测血脂四项及糖化血红蛋白含量;Western blot法检测葡萄糖转运蛋白(Glut)Glut1、Glut2、Glut4的表达;RT-PCR检测Glut2、Glut4和mRNA的表达。 结果 T2DM+OB+OW组及T2DM组FPG、2 hPG、HbA1c水平[FPG:(8.90±3.70), (9.30±2.80)mmol/L vs (3.90±0.70),(4.10±0.90) mmol/L;2 hPG: (20.10±3.50), (18.48±4.59)mmol/L vs (6.70±0.80),(6.60±0.75) mmol/L;HbA1c：(9.9±3.19)%，(8.68±2.75)% vs(5.05±0.37)%, (5.47±0.59)% ]均高于OB+OW、NC组(P<0.01);T2DM+OB+OW、T2DM及OB+OW组TC和TG水平[TC：(5.06±0.97)，(5.13±1.27)(4.67±0.83)mmol/L vs(3.51±0.89)mmol/L;TG：(3.52±2.68)，(3.79±3.56)，(1.87±0.95)mmol/L vs(1.41±1.21)mmol/L] 均高于NC组(P<0.01);

　　OB+OW组FIns水平[(7.98±2.01)vs (5.91±3.02), (5.49±1.36)mmol/L]高于T2DM、NC组(P<0.05)。T2DM+OB+OW、T2DM组Glut1，Glut2，Glut4表达均低于OB+OW、NC组(P<0.01);T2DM+OB+OW组Glut2表达低于T2DM组;T2DM+OB+OW、T2DM组Glut2和Glut4的mRNA表达低于OB+OW、NC组;T2DM+OB+OW、T2DM组ERK的mRNA表达高于OB+OW、NC组。 结论 糖尿病肥胖患者体内Glut1、Glut2和Glut4的表达均降低，其中，Glut2和Glut4的表达与ERK的表达呈负相关。

　　[关键词] 糖尿病，2型;葡萄糖转运蛋白(GLUT);ERK

　　[Abstract] Objective To investigate the relationship between plasma glucose transporter (Glut)expression and ERK in diabetic patients with obesity. Methods Subjects in this study included type 2 diabetes (T2DM) with overweight or obesity(T2DM+ OB/OW group, n=20), T2DM with normal weight (T2DM group, n=22), normal glucose with overweight or obesity(OB/OW group, n=20), normal glucose with normal weight (NC group,n=21). Automatic biochemical analyzer was used to detect the glucose concentrations; colorimetry was used to detect blood lipid; ELISA was used to detect the level of insulin; Western blot was used to evaluate the expression of Glut1 Glut2 and Glut4; RT-PCR was used to evaluate the mRNA expression of Glut2, Glut4 and ERK. Results Fasting plasma glucose(FPG)and two-hour postprandial plasma glucose (2 hPG)in group T2DM+ OB/OW[(8.9±3.7),(20.1±3.5)mmol/L]and T2DM[(9.3±2.8),(18.48±4. 59)mmol/L]were higher than in group OB/OW[(4.10±0.90),(6.60±0.75)mmol/L ]and NC[(3.9±0.7),(6.7±0.8)mmol/L](P<0.01).Hemoglobin A1c(HbA1c) in group T2DM+ OB/OW(9.90±3.19)% and T2DM(8.68±2.75)% were higher than in group OB/OW(5.05±0.37)% and NC(5.47±0.59)%,(P<0.01).Fasting FIns in group OB/OW(7.98±2.01)were higher than in [T2DM group(5.91±3.02)and NC(5.49±1.36)(P<0.05). Total cholesterol and triglyceride in T2DM+ OB/OW group(5.06±0.97),(3.52±2.68),T2DM(5.13±1.27),(3.79±3.56)and OB/OW(4.67±0.83),(1.87±0.95)were higher than in group NC(3.51±0.89),(1.41±1.21)(P<0.01). Glut1 Glut2, Glut4 expression in T2DM+ OB/OW group, T2DMwere lower than those in group OB/OW, NC.Glut2 expression in T2DM+ OB/OW group was significantly lower than in group T2DM.Glut2 and Glut4 mRNA expression in group T2DM+ OB/OW, T2DM were significantly lower than in group OB/OW, NC.ERK mRNA expression in group T2DM+ OB/OW, T2DM were significantly higher than those in group OB/OW and NC. Conclusion Glut1, Glut2 and Glut4 expression are lower in diabetic patients with obesity, and there is a negative correlation between the expression of ERK and Glut2 and Glut4.

　　[Keyword]Diabetesmellitus，type 2;Glucose transporter protein(GLUT);ERK