改善胰岛素抵抗对2型糖尿病患者胰高血糖素样肽-1水平的影响

Effects of improved insulin resistance on the level of serum glucagon-like peptide-1 in type 2 diabetic patients

目的观察2型糖尿病患者加用罗格列酮治疗后对胰高血糖素样肽-1(GLP-1)的影响。方法用胰岛素和二甲双胍联合治疗的2型糖尿病患者共74例,随机分为观察组38例和对照组36例,观察组加用罗格列酮(4 mg/d)治疗6个月后,采用酶联免疫吸附法(ELISA)检测空腹胰高血糖素样肽-1(GLP-1),氧化酶法检测空腹血糖(FPG)和早餐后2 h血糖(2hPG)及总胆固醇(TC)和甘油三酯(TG),柱层析法检测糖化血红蛋白(HbA1c),化学发光法测定空腹胰岛素(FINS)水平。观察两组干预前后FPG、FINS、2hPG、HbA1c、TC、TG的变化及干预后GLP-1的变化。结果 两组患者年龄、糖尿病病程、体质量指数、性别差异无统计学意义(P>0.05),具有可比性;观察组经罗格列酮干预6个月后,患者血清中的FPG、2hPG、FINS、HbA1c、TC、TG水平均较治疗前显著下降(P<0.05),空腹血清GLP-1水平较对照组升高(P<0.05)。结论 罗格列酮可有效的降低2型糖尿病患者的血糖及HbA1c,改善胰岛素抵抗,促进空腹GLP-1分泌。

Objective To investigate the therapeutic effects of rosiglitazone on the level of serum glucagon-like peptide-1 （GLP-1）. Methods 74 type 2 diabetes patients, who were under insulin and mefforrrtin therapy, were divided into two groups： a） study group, in which 38 patients took use of insulin combined with rosiglitazone （4 rag/day, orally） for 6 months; b） control group, including 36 patients. Limosis serum glucagon-like peptide-1 （GLP-1）, glycated hemoglobin（ HbAlc）, and limosis insulin（FINS） were measured by enzyme-linked-immtmosorbent assay （ELISA）, col- unto chromatography and chemiluminescence, respectively. The oxidase method was applied to examine the fasting blood glucose（ FPG）, 2 h postprandial blood glucose（2hPG）、 triglycefide （TG） and total cholesterol （TC）. Changes of blood glucose, insulin, HbAlc, blood lipid and GLP-1 were observed before and after treatment. Results There were no differences in age,years of diabetes mellitus, body mass index and gender between the two groups （P 〉 0.05 ）. In the first group, FPG, 2hFG, HbAlc, FINS,TC, and TG significantly decreased after a 6-month treatment （P 〈0.05）, while the group showed an increased GLP-1 secretion compared with the control（P 〈 0.05）. Conclusions Rosiglitazone can effectively control blood glucose and HbAlc, lower insulin resistance, and increase serum levels of GLP-I in patients with type 2 diabetes.