肥胖2型糖尿病患者血浆中葡萄糖转运蛋白表达及其与细胞外信号调节激酶关系的临床观察

The relationship between plasma glucose transporter expression and ERK in diabetic patients with obesity

目的探讨肥胖T2DM患者血浆中葡萄糖转运蛋白(Glut)的表达及其与细胞外信号调节激酶(ERK)的关系。方法将研究对象分为T2DM合并超重/肥胖(T2DM+OB/OW)组、单纯T2DM(T2DM)组、糖调节正常合并超重/肥胖(OB/OW)组及正常对照(NC)组。采用全自动生化分析仪测定血糖浓度;ELISA检测血胰岛素含量;比色法检测血脂四项及HbA1c水平;Western blot检测Glut1、Glut2和Glut4蛋白的表达;RT-PCR检测Glut1、Glut2、Glut4和ERK mRNA的表达。结果 T2DM+OB/OW组及T2DM组FPG、2hPG、HbA1c水平[FPG:(8.90±3.70),(9.30±2.80)mmol/L vs(3.90±0.70),(4.10±0.90)mmol/L;2hPG:(20.10±3.50),(18.48±4.59)mmol/L vs(6.70±0.80),(6.60±0.75)mmol/L;HbA1c:(9.9±3.19)%,(8.68±2.75)%vs(5.05±0.37)%,(5.47±0.59)%]均高于OB/OW组及NC组(P<0.01);T2DM+OB/OW、T2DM及OB+OW组TC和TG水平[TC:(5.06±0.97),(5.13±1.27),(4.67±0.83)vs(3.51±0.89)mmol/L;TG:(3.52±2.68),(3.79±3.56),(1.87±0.95)vs(1.41±1.21)mmol/L]均高于NC组(P<0.01);OB/OW组FIns水平[(7.98±2.01)vs(5.91±3.02),(5.49±1.36)mmol/L]高于T2DM、NC组(P<0.05)。T2DM+OB/OW、T2DM组Glut1,Glut2,Glut4表达均低于OB+OW、NC组(P<0.01);T2DM+OB/OW组Glut2表达低于T2DM组;T2DM+OB/OW、T2DM组Glut2和Glut4的mRNA表达低于OB/OW、NC组;T2DM+OB/OW、T2DM组ERK的mRNA表达高于OB/OW、NC组。结论肥胖T2DM患者体内Glut1、Glut2和Glut4的表达均降低,其中,Glut2和Glut4的表达与ERK的表达呈负相关。

Objective To investigate the relationship between plasma glucose transporter （Glut） expression and ERK in diabetic patients with obesity. Methods Subjects in this study included type 2 diabetes （T2DM ） with overweight or obesity（T2DM＋ OB/OW group ,n=20） ,T2DM with normal weight （T2DM group ,n=22） ,normal glucose with overweight or obesity（OB/OW group ,n=20） ,normal glucose with normal weight （NC group ,n=21）. Automatic biochemical analyzer was used to detect the glucose concentrations ;colorimetry was used to detect blood lipid;ELISA was used to detect the level of insulin;Western blot was used to evaluate the expression of Glut1 Glut2 and Glut4 ;RT‐PCR was used to evaluate the mRNA expression of Glut2 ,Glut4 and ERK. Results Fasting plasma glucose （FPG ）and two‐hour postprandial plasma glucose （2 hPG）in group T2DM＋ OB/OW[（8.9 ± 3.7） ,（20.1 ± 3.5）mmol/L]and T2DM[（9.3 ± 2.8） ,（18.48 ± 4.59）mmol/L]were higher than in group OB/OW[（4.10 ± 0.90） ,（6.60 ± 0.75）mmol/L ]and NC[（3.9 ± 0.7） ,（6.7 ± 0.8）mmol/L]（P〈0.01）.Hemoglobin A1c（HbA1c） in group T2DM＋ OB/OW [9.90 ± 3.19）% ] and T2DM [（8.68 ± 2.75）% ] were higher than in group OB/OW [5.05 ± 0.37）% ] and NC[（5.47 ± 0.59）% ]（P〈0.01）.FIns in group OB/OW [（7.98 ± 2.01）μIU/ml] were higher than in T2DM group[（5.91 ± 3.02）μIU/ml]and NC[（5.49 ± 1.36）μIU/ml]（P〈 0.05）.Total cholesterol and triglyceride in T2DM ＋ OB/OW group[（5.06 ± 0.97） ,（3.52 ± 2.68）mmol/L] , T2DM[（5.13 ± 1.27） ,（3.79 ± 3.56）mmol/L]and OB/OW[（4.67 ± 0.83） ,（1.87 ± 0.95）mmol/L]were higher than in group NC[（3.51 ± 0.89） ,（1.41 ± 1.21）mmol/L]（P〈0.01）. Glut1 Glut2 ,Glut4 expression in T2DM＋OB/OW group ,T2DM were lower than those in group OB/OW ,NC.Glut2 expression in T2DM＋ OB/OW group was significantly lower than in T2DM group.Glut2 and Glut4 mRNA expression in group T2DM＋ OB/OW ,T2DM were significantly lower than in group OB/OW ,NC.ERK mRNA expression in group T2DM ＋ OB/OW ,T2DM were significantly higher than those in group OB/OW and NC.Conclusion Glut1 ,Glut2 and Glut4 expression are lower in diabetic patients with obesity ,and there is a negative correlation between the expression of ERK and Glut2 and Glut4.