短期胰岛素泵强化治疗对初发2型糖尿病患者血浆vaspin水平的影响

Effects of short-term continuous subcutaneous insulin infusion on fasting plasma vaspin levels in patients with recent-onset type 2 diabetes mellitus

目的 观察短期胰岛素泵强化治疗对初发2型糖尿病患者血浆内脏脂肪组织来源的丝氨酸蛋白酶抑制物vaspin水平的影响,探讨其与胰岛素敏感性的关系.方法 30例初发2型糖尿病患者使用胰岛素泵强化治疗2周,治疗前后采用高胰岛素-正葡萄糖钳夹术评价其胰岛素敏感性,用酶免法测定血浆vaspin及相关代谢指标.结果 2型糖尿病组空腹血浆vaspin水平高于正常糖耐量（NGT）组和糖调节受损（IGR）组.2型糖尿病组经胰岛素泵强化治疗后葡萄糖代谢率升高[（5.10±0.51对2.99±0.42）mg·kg-1·min-1,P＜0.05],稳态模型评估的胰岛素抵抗指数（HOMA-IR）降低[2.30（1.09～7.20）对4.28（1.70～6.47）,P＜0.05],同时血浆vaspin水平也显著降低[（1.19±0.57对1.83±0.55）ng/ml,P＜0.05],且vaspin水平的降低与HOMA-IR的改变呈明显正相关.结论 胰岛素泵强化治疗能有效改善2型糖尿病患者的胰岛素敏感性,降低血浆vaspin水平;且血浆vaspin水平与2型糖尿病患者胰岛索敏感性有关.

Objective To investigate the effects of short-term continuous subcutaneous insulin infusion （CSII） on plasma visceral adipose tissue-derived serine protease inhibitor （ vaspin ） levels in patients with recentonset type 2 diabetes mellitus, and to study the association between insulin sensitivity and vaspin levels.Methods Thirty patients with recent-onset type 2 diabetes mellitus were treated with CSII for 2 weeks.Euglycemic-hyperinsulinemic clamps （EHC） were performed to evaluate the insulin sensitivity in type 2 diabetes group. Plasma vaspin levels were measured by an ELISA kit. The association between plasma vaspin levels and metabolic parameters were analyzed. Results Fasting plasma vaspin levels were higher in type 2 diabetes than in impaired glucose regulation and normal glucose tolerance groups [（ 1.83±0.55 vs 0. 43±0.21 and 0.56±0.26） ng/ml,P〈0.05]. With CSII,vaspin levels [（ 1.19 ±0.57 vs 1.83 ±0.55 ） ng/ml, P〈0.05] and homeostasis model assessment for insulin resistance [HOMA-IR ,2.30 （ 1.09-7.2 ） vs 4.28 （ 1.7-6.47 ）, P〈0.05] were significantly decreased,accompanied with an increase in glucose metabolic rate [（5. 10±0.51 vs 2.99±0.42 ）mg·kg-1·min-1 ,P〈0.05] in type 2 diabetes group. Changes in circulating vaspin concentrations were correlated positively with changes in HOMA-IR. Conclusion In type 2 diabetic patients,elevated plasma vaspin levels are significantly decreased after CSII treatment. Vaspin may play a role in improving insulin sensitivity of diabetic humans.