外周血白细胞计数与2型糖尿病相关研究及干预治疗

Relationship and interventing treatment of peripheral white blood cell and type 2 diabetes mellitus

目的:观察外周血白细胞(WBC)计数在2型糖尿病患者中的水平及其影响因素,并应用罗格列酮进行干预治疗,探讨罗格列酮的血管保护作用。方法:75例2型糖尿病患者应用罗格列酮4mg/d治疗,共12周,治疗前、后与55例正常对照组患者比较血糖相关指标、血压、血脂谱、vWF及WBC。结果:治疗前糖尿病组WBC(6.58±1.64)×109高于对照组WBC(5.34±0.95)×109,(P<0.05)。治疗后,血糖、糖化血红蛋白(Hb)A1c、稳态模型-胰岛素抵抗指数(HOMA-IR)、血压、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白-胆固醇(LDL-C)、vWF及WBC计数均下降(P<0.05)。以WBC计数中位数(6.4×109)分组进行相关分析,WBC计数与腰围、BMI呈正相关,WBC计数高于中位数组的腰围、BMI、TC、vWF也高于WBC低于中位数组(P<0.05)。结论:慢性亚临床炎症可能参与2型糖尿病的发生及发展。罗格列酮除降糖、改善胰岛素抵抗、调脂、降压外,还发挥抗炎、抗内皮细胞损伤的作用。

Objective： To evaluate the relationship between white blood cell count and type 2 diabetes mellitus and investigate the mechanisms of the protective effects of rosiglitazone. Methods： 75 type 2 diabetic patients received rosiglitazone （4 mg/d） for 12 weeks. WBC count and other clinical parameters were determined at baseline and after 12 weeks and in 55 normal controls. Results： In the diabetic patients, WBC were markedly higher （6.58±1.64）×10^9 as compared with normal controls （5.34±0.95）×10^9, （P〈0.05）. After treatment with rosiglitazone for 12 weeks, blood glucose,HbA1c,HOMA-IR,blood pressure, TC, TG, LDL-C, vWF and WBC （P〈0.05） were significantly reduced. WBC was positively correlated to waist （r= 0.397）, BMI （r=0.255）, respectively （P〈0.05）. Diabetic patients were divided into two groups according to median of WBC：W1 （〈6.4×10^9）group, W2 （〉6.4×10^9） group. Compared with W1 group,Waist, BMI, TC and vWF were elevated in W2 group （P〈0.05）. Conclusion： Chronic subclinical inflammation may play a role in the pathogenesis of type 2 diabetes. Rosiglitazone has anti-inflammatory effects and can improve endothelial function except lowering blood glucose, improving insulin resistance, regulating lipid metabolism and blood pressure.