胰岛素联合罗格列酮治疗2型糖尿病患者血清IL-6和脂联素水平的变化

The changes of serum level of IL-6 and adiponectin in patients with type 2 diabetes mellitus before and after treatment with insulin combining rosiglitazone

目的了解白细胞介素-6(IL-6)和脂联素在2型糖尿病患者和正常对照之间的差异以及胰岛素联合罗格列酮治疗2型糖尿病患者血清IL-6和脂联素水平的改变。方法选择无任何并发症血糖控制不佳的2型糖尿病患者30例,胰岛素联合罗格列酮治疗前后分别测定其空腹葡萄糖(FPG)、餐后2 h葡萄糖(2hPG)、糖化血红蛋白(HbA1c)、血脂、血清IL-6和脂联素水平,计算所有研究对象的体重指数(BMI),并与30名正常对照比较。结果2型糖尿病组血清IL-6水平显著高于正常对照组(P<0.05),2型糖尿病组血清脂联素水平显著低于正常对照组(P<0.05);胰岛素联合罗格列酮治疗后IL-6水平较治疗前显著降低(P<0.05),治疗后脂联素水平较治疗前显著升高(P<0.05);相关分析发现,血清IL-6水平与FPG、2hPG、HbA1c和三酰甘油(TG)呈正相关;血清脂联素水平与FPG、2hPG、HbA1c和TG呈负相关。结论IL-6作为炎症始发因子在2型糖尿病的发病中起着重要作用,脂联素能增加胰岛素的敏感性,罗格列酮通过降低IL-6水平和增加脂联素水平来减轻胰岛素抵抗和保护胰岛β细胞的功能。

Objective To investigate the serum level differences of interleukin-6 （IL-6） and adiponectin between the patients with type 2 diabetes mellitus and normal controls, the serum level changes of IL-6 and adiponectin in patients with type 2 diabetes mellitus before and after treatment with insulin combining rosiglitazone. Methods The level of fasting plasma glucose （ FPG ） , 2 h postprandial plasma glucose （ 2hPG ） , glycosylated hemoglobin （ HbA 1 c ） , serum lipids, IL-6, adiponectin and body mass index （BMI） were measured in 30 patients with type 2 diabetes mellitus which were inadequately controlled plasma glucose and no complication before and after treatment with insulin combining rosiglitazone and 30 normal controls. Results The serum level of IL-6 was significantly higher in patients with type 2 diabetes than that in normal control group （ P 〈 0. 05 ）, but the adiponectin was significantly lower （ P 〈 0. 05 ）. The serum level of IL-6 decreased significantly in patients with type 2 diabetes mellitus after treatment comparing with those before treatment （P 〈 0. 05 ）, but the adiponectin significantly increased （ P 〈 0.05 ）. Significant correlations were found between serum IL-6 and FPG, 2hPG, HbA1c, triglycerides（TG）. Significant negative correlations were found between serum adiponectin and FPG, 2hPG, HbA1c, TG. Conclusions IL-6,as the initial inflammatory factor, playes an important role in the development of type 2 diabetes mellitus. The adiponectin could enhance the sensitivity of insulin. Rosiglitazone may alleviate insulin resistance and protect β-cell by decreasing the level of IL-6 and increasing the level of adiponectin.