硫辛酸联合短期胰岛素强化对2型糖尿病周围神经病患者脂肪因子的干预作用

Effect of Alpha-lipoic Acid Combined with Transient Intensive Insulin Therapy on Adipokine Level in Patients with Type 2 Diabetic Perineuropathy

目的观察2型糖尿病周围神经病患者血清脂肪因子水平的变化,评估硫辛酸(LA)和短期胰岛素强化治疗对脂肪因子的干预作用。方法将120例2型糖尿病周围神经病患者随机分为硫辛酸治疗组和甲钴胺对照组,两组均进行胰岛素强化治疗,其中硫辛酸治疗组接受硫辛酸、甲钴胺对照组接受甲钴胺治疗共2周。在治疗前和治疗2周后测定各组生化指标和脂肪因子并比较。结果胰岛素治疗后,硫辛酸治疗组和甲钴胺对照组血清空腹血糖(FBG)、肿瘤坏死因子-α(TNFα)、超敏C反应蛋白(HSCRP)较治疗前明显降低(P均<0.05),脂联素(APN)较治疗前明显升高(P均<0.05);硫辛酸治疗组的APN明显高于甲钴胺对照组(P<0.05),TNF-α和HSCRP明显低于甲钴胺对照组(P均<0.05),瘦素治疗前后以及两组间差异均无统计学意义(P均>0.05)。结论硫辛酸联合胰岛素治疗糖尿病性周围神经病变可影响脂肪因子水平并加强胰岛素抗炎作用。

Objective To evaluate the effect of alpha-lipoic acid （LA） combined with transient intensive insulin therapy on adipokine level in patients with type 2 diabetic perineuropathy （DPN） . Methods Totally 120 type 2 DPN patients who were receiving transient intensive insulin treatment were equally and randomly divided into LA group and methycobal group （which was set as the control group） . The treatment lasted two weeks. The levels of biochemical indicators and adipokine were measured before treament and two weeks after treament. Results After treatment with insulin, serum blood-fasting glucose （FBG）, tumor necrosis factor-or （TNFa）, and hypersensitive C-reactive protein （HScaP ） were significantly decreased in both LA group and methycobal group （ all P 〈 0. 05 ）, while adiponectin （APN） significantly increased （ both P 〈 0. 05 ） . Compared with the methycobal group, the level of APN was significantly higher and those of TNFct and HScRP were significantly lower in LA group （ all P 〈 0. 05 ） . Leptin showed no significant change before and after treatment （ all P 〉 0. 05 ）. Condusion Transient intensive insulin therapy with LA treatment can regulate adpokine and enhance the anti-inflammatory effect of insulin in type 2 DPN patients.