初诊2型糖尿病患者血清RBP4水平与胰岛素抵抗的相关性

Correlation of serum retinol binding protein 4 and insulin resistance in newly diagnosed type 2 diabetes patients

目的探讨初诊2型糖尿病(T2DM)患者血清视黄醇结合蛋白4(RBP4)水平与胰岛素抵抗(IR)的相关性。方法初诊T2DM患者(A组)60例随机均分为吡格列酮干预组(A1组)和二甲双胍干预组(A2组),另选取30例健康体检者作为对照(B组),测定干预前、后各组三酰甘油(TG)、空腹血糖(FBG)、空腹胰岛素(FIns)、糖化血红蛋白(HbA1c)和RBP4,计算体重指数(BMI)、胰岛素抵抗指数(HOMA-IR)和Homeβ细胞功能指数(HBCI)。结果A组血清RBP4、FBG、HbA1c、FIns和HOMA-IR高于B组,HBCI低于B组(P<0.05)。A1、A2组干预后FBG、HbA1c、FIns、RBP4、HOMA-IR、TG低于干预前,HBCI高于干预前(P<0.05)。A1组降低FBG、HbA1c、RBP4、HOMA-IR、TG优于A2组,而A2组降低BMI优于A1组(P<0.05)。A组患者血清RBP4水平与HOMA-IR、BMI、FIns和TG呈正相关(r=0.404、0.394、0.445和0.437,P<0.05)。结论初诊T2DM患者血清RBP4水平与IR正相关,减少RBP4的分泌可改善IR,增加胰岛素敏感性,吡格列酮干预效果优于二甲双胍。

Objective To investigate the correlation of serum retinal binding protein 4（RBP4）and insulin resistance（IR）in the patients newly diagnosed type 2diabetes mellitus（T2DM）.Methods Sixty newly diagnosed T2 DM patients（group A）were equally randomized into two groups of A1（treated with pioglitazone）and A2（treated with metformin）.Thirty healthy people were taken as the controls（group B）.The levels of triacylglycerol（TG）,fasting blood glucose（FBG）,fasting insulin（FIns）,glycosylated hemoglobin（HbA1c）and RBP4 were detected.The body mass index（BMI）,homeostasis model assessment-insulin resistance index（HOMA-IR）and Homeβcell function index（HBCI）were calculated.Results Serum levels of RBP4,FBG,HbA1 c,FIns and HOMA-IR were higher and HBCI was lower in group A than those in group B（P〈0.05）.Compared with before,the levels of FBG,HbA1 c,FIns,RBP4,TG and HOMA-IR were decreased amd HBCI was increased in groups of A1 and A2after the intervention（P〈0.05）.After the intervention,the levels of FBG,HbA1 c,RBP4,TG and HOMA-IR were lower and BMI was higher in group A1 than those in group A2（P〈0.05）.Serum level of RBP4 was positively correlated with that of HOMA-IR,BMI,FIns and TG in group A（r=0.404,0.394,0.445 and 0.437,P〈0.05）.Conclusion RBP4 level in newly diagnosed T2 DM patients is positively correlated with IR.The effect of pioglitazone intervention is better than metformin in reducing the secretion of RBP4,which can improve IR and enhance insulin sensitivity.