探讨骨骼肌细胞葡萄糖转运蛋白4含量在早发2型糖尿病患者中的特点

Investigation on changes of skeletal muscle cells glucose transporter 4 in early-onset type 2 diabetes mellitus

目的探讨骨骼肌细胞葡萄糖转运蛋白4(GLUT4)蛋白含量在早发2型糖尿病(T2DM)患者中的特点。方法试验共分为4组:年轻非糖尿病对照组(YN),老年非糖尿病对照组各6例(ON);早发T2DM(EOD)和晚发T2DM各8例(LOD),手术前当天抽取患者空腹血,测定FPG、HbA1c、FINS;手术中取骨骼肌组织约500mg,应用Westernblot方法测定各组骨骼肌细胞GLUT4蛋白含量。结果糖尿病组的FPG和HbA1c水平均高于非糖尿病对照组,EOD组患者血糖和HbA1c高于LOD组,差异有显著性;糖尿病组中的GLUT4蛋白含量低于非糖尿病对照组(P<0.05);EOD组中骨骼肌细胞GLUT4蛋白含量高于LOD组(P<0.05);通过相关分析发现,在糖尿病组中骨骼肌GLUT4蛋白水平和WHR、HOMAIR以及腰围呈负相关。结论骨骼肌细胞GLUT4蛋白含量降低,在2型糖尿病人胰岛素抵抗的发生过程中起到了一定的作用;早发2型糖尿病人胰岛素抵抗程度较轻,可能和骨骼肌细胞中GLUT4含量较高有关。

[Objective] To investigate glucose transporter 4（GLUT4） protein content in skeletal muscle cells of early-onset T2DM and to evaluate its potential molecular mechanism in the pathogenesis of early-onset T2DM. [Methods] Totally 28 patients given opportunity selected operation were enrolled and all agreed the consent. They were divided into four groups： Young non-diabetic control group （YN, n =6）, Old non-diabetic control group （ON, n=6）, Early-onset T2DM group（EOD, n =8）, Late-onset T2DM group （LOD, n =8）. The fasting blood was taken on the day before operation to determine the fasting blood glucose（FPG）, HbAlc and fasting insulin（FINS）. About 500 nag skeletal muscle was removed during the operation for GLUT4 protein analysis. The technique of Western blot was used to detect the concent of GLUT4 protein in skeletal muscle cells. [Results] The value of FPG and HbAlc in diabetic group were higher than those in non-diabetic group. Compared with LOD group, the mean value of FPG and HbAle were significantly higher in EOD group. The level of GLUT4 protein content in diabetic group was lower than that in non-diabetic group. Compared with LOD group, the level of GLUT4 protein was higher in EOD group （P〈0.05）. In diabetic group the content of GLUT4 protein was negatively correlated with WHR, HOMAIR and waist. [Conclusion] The content of GLUT4 protein of skeletal muscle may play a role in insulin resistance in type 2 diabetes mellitus. Compared with LOD group, the relative high level of GLUT4 protein in skeletal muscles cells may associated with lower insulin resistance in EOD group.