2周胰岛素强化治疗对口服药失效的2型糖尿病患者外周血核因子κB的影响

The influence of intensive insulin therapy on nuclear factor-kappa B of PBMCs in type 2 diabetics with oral antidiabetic drug failure

目的比较胰岛素强化治疗前后口服抗糖尿病药失效2型糖尿病(T2DM)患者外周血单核细胞中核因子κB(NF-κB)表达水平的变化,探讨胰岛素的抗炎作用。方法选择对照组20名(NC组),口服药失效的T2DM患者20例(DM组)给予胰岛素强化治疗2周。检测DM组治疗前后空腹血糖(FBG)、空腹胰岛素(Fins)和c肽以及餐后2hBG、胰岛素和c肽水平的变化及采用流式细胞仪(FCM)、竞争性酶联免疫吸附法(ELISA)检测治疗前后外周血单核细胞NF-κB表达水平的变化。结果与NC组比较,T2DM患者外周血单核细胞NF-κB表达升高(P<0.01);与治疗前比较,胰岛素强化治疗2周后,NF-κB表达降低(P<0.01);FBG、2hBG和HOMA-IR降低;胰岛素、C肽和HOMA-β升高。结论 T2DM患者2周胰岛素强化治疗后,血糖明显改善的同时,单核细胞中NF-κB表达明显降低。

Objective To investigate the effect of insulin on the level of NF-gB expressions of peripheral blood mononuclear cells（PBMCs） in type 2 diabetics with oral antidiabetic drugs failure. Methods 20 normal subjects （NC group） were recruited. Type 2 diabetics with oral antidiabetic drugs failure （n=0, DM group） were given intensive insulin therapy for two weeks. FBG, Fins, fasting C- peptide and 2h levels of PBG, insulin, C-peptide were tested in the DM group before and after treatment. The expressions of NF-κB were measured by using ELISA and flow cytometry. Results The expression of NF-κB in DM group was higher than in controls （P〈0. 01）, lower after therapy than before treatment （P〈0.01）. Blood glucose and HOMA-IR were decreased and insulin, C-peptide and HOMA-β were increased in post-treatment versus pre-treatment. Conelesions Intensive insulin therapy is capable of alleviating the elevated inflammation reaction resulting in reduction of the expressions of NF-κB on PBMCs in type 2 diabetics.