氯喹对2型糖尿病患者的代谢紊乱及胰岛素酶基因表达的影响

Effect of chloroquine on the metabolic disorders and expression of insulinase gene in patients with type 2 diabetes mellitus

目的 了解氯喹改善 2型糖尿病患者的葡萄糖、脂质及胰岛素紊乱的效果 ,以及该药对胰岛素酶 (IDE)基因表达的影响。方法 随机选择服用磷酸氯喹 (0 .5 g/ d× 14d)的 2型糖尿病患者 30例 ,服用安慰剂的 2型糖尿病患者 2 7例以及正常对照组 2 0例。对两组糖尿病患者服药前后以及正常对照的空腹血糖 (FPG)、糖基化血红蛋白 (Hb A1c)、空腹血浆胰岛素 (FINS)、血脂、红细胞 IDE活性 (EIA)以及胰岛素酶基因表达量 (EIG)进行了检测 ,并计算胰岛素敏感性指数 (ISI)。结果 服用氯喹后 ,患者的 FPG、TC、L DL、EIA和 EIG显著下降 ,HDL、HDL2 、ISI显著上升 ,而 FINS和Hb A1c无明显变化。服用安慰剂的患者上述指标无明显变化。结论 氯喹能明显改善 2型糖尿病患者的糖、脂代谢紊乱和胰岛素敏感性 ,其作用机理可能与抑制患者的胰岛素酶基因表达从而降低胰岛素降解速度有关。

Objective To investigate the effects of chloroquine on metabolism of insulin,glucose,lipids and expression of insulinase gene (EIG) in patients with type 2 diabetes mellitus.Methods Fasting plasma insulin (FINS),fasting plasma glucose (FPG),glycoslated hemoglobin (HbA1c),plasma lipids and lipoprotein,insulinase activity of erythrocytes (EIA) and EIG were determined in 30 patients with type 2 diabetes mellitus laking chloroquine for 14 day in dosage of 250mg twice daily,27 diabetic patients laking placebo and 20 normal subjects.Insulin sensitive index (ISI) were also calculated.Results Chloroquine caused a decrease in total plasma cholesterol,low density lipoprotein,EIA and EIG,and an increase in ISI,plasma high density lipoprotein and subclass 2.No change of these indices was observed in diabetic patients with placebo.Conclusion Chloroquine can ameliorate the dyslipidemia and insulin sensitivity of patients with type 2 diabetes mellitus.This may be due to a decrease in EIG,which may result in lowered degradation of insulin.