胰岛素增敏剂对2型糖尿病大血管病变患者金属基质蛋白酶9的影响及意义

The impact of matrix metalloproteinase 9 in type 2 diabetic patients with macroangiopathy after application of Insulin sensitizers

目的:观察胰岛素增敏剂治疗对2型糖尿病患者(T2DM)金属基质蛋白酶-9(MMP-9)表达改变的影响。方法:188例T2DM患者随机分为对照组和干预组,均给予正规糖尿病治疗,干预组加用罗格列酮8mg,qd。在治疗前和治疗后2个月时分别采用ELISA检测血清MMP-9的表达量。结果:治疗前有大血管病变组患者的MMP-9值明显高于无大血管病变组者(t=3.325,P=0.001)。治疗后对照组的MMP-9值较治疗前未有有统计意义的下降(t=0.800,P=0.425);而干预组的MMP-9值较治疗前明显下降(t=4.405,P=0.000);治疗后干预组的MMP-9值较对照组明显下降(t=3.431,P=0.001)。分层分析显示罗格列酮干预对有大血管病、代谢综合征的T2DM患者,治疗后MMP-9改变更为明显。结论:胰岛素增敏剂罗格列酮能够减慢2型糖尿病患者大血管动脉粥样硬化的进程,这种作用在已经存在大血管病变和代谢综合征的2型糖尿病患者表现更为明显。

Objective： To observe the impact of matrix metalloproteinase -9 （MMP-9） expression in application of insulin sensitizer in type 2 diabetes （T2DM）. Methods： 188 patients with T2DM were randomly divided into control group and in- tervention group. All of them were given the formal treatment of diabetes, the intervention group added with rosiglitazone 8 mg,qd. Before the treatment and two months after treatment, serum MMP-9 expression were detected by ELISA. Results： Before treatment, MMP-9 in patients with macroangiopathy was significantly higher than those without macroangiopathy （t= 3.325,P=0.001）. After treatment, the MMP-9 did not have statistically significant decrease （t=0.800,P=0.425） in the control group; while in the intervention group, the MMP-9 decreased significantly （t=4.405,P=0.000 ）; after treatment, the MMP-9 in intervention group decreased significantly than that of the control group （t=3.431,P=0.001）. Stratification analysis showed that MMP-9 change more apparent after rosiglitazone intervention in patients with macroangiopathy , the same as metabolic syndrome T2DM patients. Conclusion： Rosiglitazone can slow down macrovascular atherosclerosis process in patients with type 2 diabetes, this effect become more evident in T2DM with macrovascular diseases or metabolic syndrome.