二甲双胍对不同谷氨酸脱羧酶抗体表达糖耐量受损患者血清白细胞介素-6、C反应蛋白及胰岛β细胞功能的影响

The Effects of Metformin on the Serum Levels of IL-6, CRP and the Function of β-cell in IGT Patients with Different Expression Levels of GADA

目的观察二甲双胍对谷氨酸脱羧酶抗体(GADA)阳性及阴性糖耐量受损(IGT)患者血清白介素6(IL-6)、C反应蛋白(CRP)及胰岛β细胞功能的影响。方法选取GADA阳性IGT患者20例、GADA阴性IGT患者40例及正常对照30例,两组IGT患者予二甲双胍治疗8周,观察治疗前后血压、血脂、血糖、IL-6、CRP和胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-IS)的变化,并与对照组比较。结果GADA阳性和阴性组治疗前空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1C)、CRP、HOMA-IR均高于对照组,HOMA-IS低于对照组。二甲双胍治疗8周后两组血压、血脂、BMI、IL-6较治疗前均无明显变化,而CRP[(0.89±0.22)、(0.91±0.25);(0.54±0.23)、(0.49±0.21)mg/L]、HOMA-IR(6.42±2.3,6.02±1.9;4.90±2.0,4.86±2.1)、FPG([5.9±1.4)、(5.7±1.3);(5.2±0.7)、(4.6±0.6)mmol/L]、2hPG([9.1±1.8)、(10.2±2.3);(7.2±1.6)、(7.3±1.8)mmol/L]均较治疗前降低(P<0.05或P<0.01),HOMA-IS(2.04±0.12、2.03±0.17;2.53±0.14、2.73±0.18)升高(均P<0.05),HbA1C亦较治疗前降低,但无统计学意义;两组HOMA-IR均与CRP呈正相关(r1=0.338,r2=0.364,P<0.05)。结论部分GADA阳性IGT患者亦存在不同程度的胰岛素抵抗和胰岛β细胞功能障碍。二甲双胍可显著降低CRP水平,改善胰岛β细胞功能。

Objective To observe the effects of mefformin on the serum levels of IL-6, CRP and β-cell function in IGT patients with different expression levels of GADA. Methods 20 of IGT patients with expression of GADA, 40 IGT patients without expression of GADA and 30 normal healthy controls were involved in the study. Two groups of IGT patients were given treatment of mefformin for 8 weeks. The changes of serum levels of IL-6, CRP, HOMA-IR and HOMA-IS were observed before and after the treatment of mefformin. Results Before treatment of mefformin, levels of FPG, 2hPG, HbA1c, CRP, HOMA-IR in two groups of IGT patients were all higher and HOMA-IS were lower than those in normal controls. After eight weeks of treatment with mefformin, the levels of BP, IL-6, BMI, TC and TG were not significantly changed, but CRP （0.89±0.22,0.91±0.25 vs 0.54±0.23, 0.49±0.21）, HOMA-IR （6.42±2.3, 6.02±1.9 vs 4.90±2.0, 4.86±2.1）, FPG （5.9±1.4, 5.7±1.3 vs 5.2±0.7, 4.6±0.6）, 2hPG （9.1±1.8, 10.2±2.3 vs 7.2±1.6, 7.3±1.8）, HbA1c （7.8±0.4, 7.7±0.6 vs 6.3±0.3, 6.2±0.4）were decreased （P〈0.05 or P〈0.01）, HOMA-IS （2.04±0.12, 2.03±0.17 vs 2.53±0.14, 2.73±0.18）were increased （all P〈0.05）. Conduslon Mefformin may reduce the serum CRP level, improve the function of β-ceil in both IGT patients with and without expression of GADA.