罗格列酮对初诊为2型糖尿病患者血清SPARC的影响

Effect of rosiglitazone on serum SPARC in patients with newly diagnosed type 2 diabetes mellitus

目的探讨罗格列酮对初诊为2型糖尿病(T2DM)患者血清富含半胱氨酸的酸性分泌蛋白(SPARC)水平的影响。方法纳入2013年3月1日至2014年2月28日在该院初诊为T2DM患者78例,随机分为罗格列酮治疗组(40例)和运动饮食控制组(38例),另同期选取53例年龄匹配的健康体检者作为健康对照组。罗格列酮治疗组患者给予罗格列酮钠4 mg,每天1次口服,治疗16周;运动饮食控制组患者参照《中国2型糖尿病防治指南(2010年版)》进行生活方式干预16周。比较各组治疗前后的体质量、体质量指数(BMI)、血脂及胰岛素抵抗相关指标,采用酶联免疫吸附试验(ELISA)测定血清SPARC水平,并比较干预前后的水平变化。结果治疗前,罗格列酮治疗组、运动饮食控制组患者血清SPARC水平均显著高于健康对照组,差异有统计学意义(P<0.05)。治疗后,罗格列酮治疗组、运动饮食控制组患者血清SPARC水平均较治疗前有所下降,差异有统计学意义(P<0.05),而罗格列酮治疗组血清SPARC水平降低幅度与运动饮食控制组比较,差异无统计学意义(P>0.05)。结论 T2DM患者空腹血清SPARC水平较健康人增高。罗格列酮降低了血清SPARC水平,其作用与饮食及运动治疗相当。

Objective To investigate the effect of rosiglitazone on the levels of secreted protein acidic and rich in cys teine（SPARC） in the patients with type 2 diabetes mellitus（T2DM）. Methods Seventy-eight patients with newly diagnosed T2 DM in our hospital from March 1,2013 to February 28,2014 were included and randomly divided into the rosiglitazone treatment group（40 cases） and exercise diet control group（38 cases）. Contemporaneous 53 age-matched individuals undergoing the healthy physical examination were selected as the healthy control group. The treatment group was treated with rosiglitazone 4mg once daily for 16 weeks;the exercise diet control group was conducted the 16-week life style intervention by referring to the Chinese Type 2Diabetes Prevention and Control Guide（version 2010）. The body weight,BMI,blood lipid and insulin resistance related indexes in various groups were compared before and after intervention. Serum SPARC level was assayed by ELISA and its changes were compared between before and after treatment. Results The serum level of SPARC before treatment in the treatment group and the exercise diet control group were significantly higher than that in the healthy control group,the difference was statistically significant（P〈0.05）. The serum level of SPARC after treatment in the rosiglitazone treatment group and exercise diet control group was decreased with statistical difference（P〈0.05）,but the decrease amplitude had no statistical difference between the rosiglitazone group and the exercise diet control group（P〉0.05）. Conclusion The level of fasting serum SPARC in the patients with T2 DM is increased compared with healthy persons. Rosiglitazone reduces serum SPARC level and its effect is equivalent to diet and exercise therapy.