胰岛素对新诊断2型糖尿病患者胰岛B细胞的保护作用研究

Protective Effects of Insulin on Islet B Cells in Newly Diagnosed Type 2 Diabetic Patients

目的:探讨胰岛素对新诊断2型糖尿病患者胰岛B细胞的保护作用。方法:将86例新诊断2型糖尿病患者随机分为观察组和对照组,观察组患者应用胰岛素治疗,对照组患者采用口服降糖药治疗。在所有患者血糖达标并稳定2个月后,比较2组患者血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL);胰岛B细胞功能指标胰岛素分泌指数(Homa-β)、胰岛素抵抗指数(Homa-IR)、C肽葡糖糖负荷曲线下面积(AUCcp)、胰岛素早相分泌功能指数(IG30)及氧化应激指标活性氧活力(ROS)、丙二醛(MDA)、还原型谷胱甘肽(GSH)、超氧化物歧化酶(SOD)。结果:2组患者血糖达标且无显著性差异时,治疗组患者TG、TC、LDL均明显低于对照组,差异有统计学意义(P<0.05或P<0.01);治疗组Homa-IR较对照组下降(P<0.05),Homa-β、AUCcp、IG30均高于对照组(P<0.01);治疗组ROS、MDA明显低于对照组,GSH、SOD均高于对照组(P<0.01)。结论:2型糖尿病患者早期应用胰岛素强化控制血糖,可有效改善体内代谢异常,改善胰岛B细胞功能和体内的氧化应激状态。

OBJECTIVE： To investigate the protective effects of insulin on islet B cells in newly diagnosed type 2 diabetes mellitus patients. METHODS： 86 patients with newly diagnosed type 2 diabetes were randomly assigned into observation group and control group. Observation group received insulin therapy while control group was given oral dose. 2 month after fulfilled and stable blood glucose control, TC, TG, LDL, HDL , Homa-β, Homa-IR, AUCcp, IG30, and oxidative stress indicators ROS, MDA, GSH, SOD were detected and compared between 2 groups. RESULTS： There was no significant difference between 2 groups after fulfilled blood glucose control. TG, TC, LDL of treatment group were significantly lower than those of control group, there were significant difference （P0.05 or P0.01）; Homa-IR of treatment group decreased, compared with control group （P0.05）. Homa-β, AUCcp and IG30 of treatment group were higher than those of control group （P0.01）; ROS and MDA of treatment group were significantly lower than those of control group, GSH and SOD of treatment group were those of control group （P0.01）. CONCLUSION： For the newly diagnosed type 2 diabetic patients, early use of intensive therapy of insulin for blood glucose control not only improve the body metabolism and protect the islet B cells function, but also make oxidative stress better.