不同干预治疗对初诊2型糖尿病患者胰岛素抵抗、血清游离脂肪酸和廋素的影响

The Changes of HOMA-IR,FFA and Leptin in Newly Diagnosed Type 2 Diabetes(T2DM) in Treatment with CSII or MDI

目的探讨胰岛素泵持续皮下胰岛素输注(CSII)或胰岛素多次注射(MDI)对初诊2型糖尿病(T2DM)患者胰岛素抵抗(HOMA-IR)、血清游离脂肪酸(FFA)和廋素(Leptin)的影响。方法52例T2DM合并血脂异常患者根据胰岛素强化治疗方式随机分为CSII组与MDI组,分别在治疗前、治疗后(第22天)观察胰岛素抵抗、血清游离脂肪酸和廋素变化,并与正常健康体检者进行对照。对3组HOMA-IR、FFA和Leptin水平进行相关回归分析。结果治疗前CSII组与MDI组的HOMA-IR、FFA与Leptin明显高于正常对照组(P<0.05),治疗后2组患者的HOMA-IR、FFA明显低于治疗前(P<0.05)。3组治疗前后的FFA与Leptin、HOMA-IR均有正相关关系,FFA与Leptin在治疗前后无相关关系。回归分析表明,FFA与Leptin在治疗前及治疗后均是影响HOMA-IR的重要因素。结论两种干预方式均可明显改善初诊T2DM患者的HOMA-IR、FFA水平,FFA、Leptin均与HOMA-IR呈正相关关系,是影响胰岛素抵抗的重要因素。

OBJECTIVE To investigate the changes of HOMA-IR, FFA and Leptin in newly diagnosed type 2 diabetes （T2DM）in treatment with CSII or MDI. METHOD 52 patients were with newly diagnosed T2DM were randomized in CSII group and MDI group by different insulin intervention methods HOMA-IR, FFA and Leptin level in 2 groups and 26 normal subjects as normal control group were measured before the treatment and after 21-day-treatment later. Correlation and regression analysis were analyzed among HOMAIR,FFA and Leptin. RESULTS The level of HOMA-IR,FFA and Leptin level were higher than those of normal control group （P〈0.05）. The level of HOMA-IR and FFA level after 21-day-treatment were improved significantly（P〈0.05 ）. The level of HOMA-IR and Leptin were higher than those of normal control group（P〈0.05 ）. FFA and leptin were positively correlated with HOMA-IR and there is no relationship between FFA and leptin. CONCLUSION CSII or MDI both can improve HOMA-IR,FFA and Leptin level in newly diagnosed T2DM patients and FFA and leptin were positively correlated with HOMA-IR which were contribution to insulin resistance.