短期胰岛素泵治疗对初诊2型糖尿病患者脂肪细胞因子的影响

Influence of Short-Term Continuous Subcutaneous Insulin Infusion Therapy on Adipocyte Cytokines in Newly Diagnosed Type 2 Diabetes

目的通过对初诊2型糖尿病(T2DM)患者进行短期持续皮下胰岛素输注(CSⅡ),观察短期强化血糖控制后患者游离脂肪酸(FFA)、脂联素等脂肪细胞因子的动态变化。方法28例初诊T2DM患者接受为期14d的CSⅡ治疗,于治疗前、治疗3d后和治疗14d后分别测定空腹血糖(FPG)、血胰岛素、胰岛素原、FFA和脂联素水平,计算胰岛素抵抗指数(HOMA-IR),比较CSII治疗前、后上述各项指标的变化。结果(1)治疗3d后和14d后患者FPG、HOMA-IR均较治疗前显著降低(P<0.05),治疗14d后FPG水平和HOMA-IR较治疗3d后进一步降低(P<0.05),差别有统计学意义;(2)胰岛素原于治疗3d后和14d后均较治疗前显著下降,差别有统计学意义(P<0.05),但治疗14d后与治疗3d后相比,差别无统计学意义(P>0.05);(3)治疗14d后FFA和脂联素水平较治疗前显著降低,差别有统计学意义(P<0.05)。结论对初诊T2DM患者进行短期胰岛素泵强化治疗,能增加脂联素水平,降低FFA水平,改善患者脂毒性、β细胞功能与胰岛素抵抗程度。

Objective To observe the influence of short - term continuous subcutaneous insulin infusion （ CSⅡ ） on adipocyte cytokines of free fatty acid （FFA） and adiponectin in newly diagnosed type 2 diabetes. Methods Totally 28 inpatients with newly diagnosed type 2 diabetes accepted CSII therapy for 14 days. Fasting blood glucose （FBG） , insulin, proinsulin, FFA, and adiponectin were examined respectively; and Homa - IR was calculated. The changes of these items before and after CSⅡ for 3 days and 14 days were compared. Results FBG level and Homa - IR decreased significantly after CSⅡ for 3 days and 14 days （ P 〈 0. 05 ）, and the result for 14 days was better than that for 3 days （ P 〈 0. 05）. Proinsulin and FFA levels decreased significantly after CSⅡ for 3 days and 14 days （P 〈 0. 05 ） , but there was no statistic difference between the results for 14 days and for 3 days （ P 〉 0. 05, and adiponectin level increased after CSⅡ for 3days and 14days, but only the change for 14days was of significant difference. Conclusion The short - term intensive insulin therapy for newly diagnosed type 2 diabetes can raise proinsulin level, reduce, PFF level, and improve lipid toxicity, β -cell function and insulin resistance.