罗格列酮对初发2型糖尿病合并肥胖患者炎症状态及胰岛素抵抗的影响

Effects of rosiglitazone on inflammatory reaction and insulin resistance in obese patients with newly diagnosed type 2 diabetes

目的探讨罗格列酮对初发2型糖尿病合并肥胖患者血清高敏C反应蛋白(hs-CRP)、白介素-1β(IL-1β)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及胰岛素抵抗的影响。方法118例初发2型糖尿病合并肥胖患者随机分为两组:A组口服罗格列酮(4mg/d)12周,B组予磺脲类降糖药物治疗12周。检测两组患者治疗前后血清中hs-CRP、IL-1β、IL-6、TNF-α水平及空腹血糖(FPG)、空腹血浆胰岛素(FINS)浓度,根据HOMAModel公式计算胰岛素抵抗指数。结果A组患者治疗后血清hs-CRP、IL-1β、IL-6、TNF-α水平及空腹血糖、胰岛素抵抗指数显著低于治疗前(P<0.01);治疗后A组患者空腹血糖较B组患者无明显差异(P>0.05),但血清hs-CRP、IL-1β、IL-6、TNF-α水平及胰岛素抵抗指数显著低于B组患者(P<0.05)。结论罗格列酮降低2型糖尿病合并肥胖患者血糖同时,降低患者机体炎症状态,改善胰岛素抵抗。

Objective To study the effect of rosiglitazone on serum high-sensitivity C-reactive protein （hs-CRP）, interleukin-1β （IL-1β）, IL-6, tumor necrosis factor-α （TNF-α） and insulin resistance in obese patients with newly diagnosed type 2 diabetes. Methods This study involved 118 patients with newly diagnosed type 2 diabetes and obesity, who were randomly assigned into two groups for a 12-week treatment with rosiglitazone （4 mg/day, group A） or sulfonylureas （group B）. Serum hs-CRP, IL- 1β, IL-6, TNF-α, fasting plasma glucose （FPG） and fasting insulin （FINS） were measured before and after the treatment. Insulin resistance index was calculated according to the HOMA Model. Results In group A, rosiglitazone treatment resulted in significantly reduced serum hs-CRP, IL-1β, IL-6, TNF-α, FPG and insulin resistance index （P〈0.01）. No difference in FPG was found between the two groups afeer the treatment （P〉0.05）, but serum hs-CRP, IL-1β, IL-6, TNF-α and insulin resistance index were significantly lower in group A than in group B （P〈0.05）. Conclusion Rosiglitazone can decrease FPG, reduce the inflammation reaction and improve insulin resistance in obese patients with type 2 diabetes.