罗格列酮对2型糖尿病血清脂联素与炎性因子的影响

Effects of Rosiglitazone on Adiponectin Level and Inflammatory Factors in Type 2 Diabetes Mellitus

目的了解2型糖尿病的血清脂联素与炎性因子水平变化及罗格列酮(RSG)对它们的影响。方法将97例受试者分为4组:正常对照组(NGT)、糖耐量低减组(IGT)、2型糖尿病未合并大血管病变组(DM1)和2型糖尿病合并大血管病变组(DM2)。所有病人应用RSG(4mg/d)治疗16周后,观察C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)的水平变化。结果从NGT、IGT、DM1到DM2组其血清脂联素水平依次明显下降,每组间下降均具有显著意义(P<0.01)。血浆CRP、TNF-α从NGT、IGT、DM1到DM2组其浓度依次逐渐上升。每个组间上升均具有显著意义(P<0.01);经RSG治疗后IGT组、DM1组血清脂联素水平明显上升、CRP水平明显下降(P<0.05),治疗后TNF-α在IGT组明显下降(P<0.05)。结论IGT和2型糖尿病患者血清脂联素明显降低,其炎性因子的水平明显增高。RSG能升高血清脂联素水平,不同程度地降低炎性因子水平,RSG对IGT和2型糖尿病的心血管具有保护作用。

Objective To investigate the changes of adiponectin （ANP）level and inflammatory factors in type 2 diabetes mellitus（T2DM） and effects of rosiglitazone （RSG） on these markers. Methods 97 subjects in this study were 22 healthy subjects （NGT）, 21patients with impaired glucose tolerance （IGT） and 54 patients with T2DM. T2DM group was further divided into T2DM without macrovascular complication（DM1,28 cases） and T2DM with macrovascular comphcation （DM2,26 cases ）. All of patients were treated with 4 mg RSG daily, after 16 weeks the adiponectin level and inflammatory factors including serum C-reactive protein （CRP）,Tumor necrosis factor-α TNF-α）were detected. Results The levels of adiponectin were decreased more increasingly from NGT,IGT, DM1 to DM2 group with significant differences between any groups （P 〈 0.05 or P 〈 0,01 ）,and the levels of CRP and TNF-α were gradually elevated more increasingly from NGT, IGT, DM1 to DM2 group with significant differences between any groups （P 〈 0.05 or P 〈 0.01 ）. Serum adiponectin in IGT and T2DM groups increased significantly, CRP in IGT and T2DM groups decreased significantly, and TNF-α decreased significantly after the treatment with RSG, Conclusion In patients with T2DM, the level of adiponectin is significantly decreased and the levels of inflammatory factors are significantly increased. RSG effectively suppresses the variation and it may have macrovascular protective effect on patients of IGT and T2DM.