二甲双胍、津力达联合胰岛素控制血糖对脂联素的影响

Influence of Metformin,Jinlida Combined with Insulin on Adiponectin in Control of Blood Glucose

目的:通过二甲双胍、津力达分别联用胰岛素,了解2型糖尿病(T2DM)患者脂联素变化。方法:选取150例血糖控制不理想的2型糖尿病患者,随机分为三组,每组50例,A组予胰岛素(优泌乐25)皮下注射控制血糖,B组采用二甲双胍联合优泌乐25,C组采用津力达联合优泌乐25。治疗12周,观察三组治疗后的体重指数(BMI)、血糖、血脂、糖化血红蛋白(HbA1c)、空腹血清胰岛素(FINS)、HOMA胰岛素抵抗指数(HOME-IR)、脂联素(APN)等指标变化。结果:治疗后,B、C组BMI均下降,B组较C组BMI下降程度有统计学意义(P<0.05);治疗后三组的空腹血糖(FPG)、餐后2h血糖(2hPG)、HbA1c、甘油三酯(TG)、总胆固醇(TC)、HOME-IR均明显下降(P<0.01),A组FINS下降(P<0.05),B、C组FINS下降(P<0.01);治疗12周,C组胰岛素用量低于B组(P<0.05);治疗后B、C组的APN均升高(P<0.05),C组APN升高幅度较B组略高,但APN升高差异无统计学意义(P>0.05),A组APN无明显改变。结论:二甲双胍及津力达均可使APN水平升高。对于血糖控制差,且不适宜服用二甲双胍的T2DM,给予津力达,同样达到减轻胰岛素抵抗、降糖、降脂、改善血糖达标率。

Objective:To investigate the changes of adiponectin in type 2 diabetes mellitus(T2DM)by using metformin,jinlida respectively combined with insulin.Methods:150 patients of type 2 diabetes mellitus with poor blood glucose were divided into three groups randomly,50 cases each group.Group A received subcutaneous injection of insulin(Humalog Mix 25)to control blood glucose,group B received metformin combination with Humalog Mix 25,group C received jinlida combination with Humalog Mix 25.Body mass index(BMI),blood glucose,blood lipid,glycosylated hemoglobin(HbA1c),fasting serum insulin(FINS),HOMA insulin resistance index(HOME-IR),adiponectin(APN),and other indicators were observed after 12 weeks treatment in three groups.Results:BMI of both group B and group C decreased after treatment,BMI of group B decreased significantly compared with group C(P<0.05);all groups of FPG,2hPG,HbA1c,TG,TC,HOME-IR decreased significantly after treatment(P<0.01),FINS of group A decreased(P<0.05),FINS of group B and C decreased(P<0.01);After 12 weeks of treatment,insulin dosage of group C decreased significantly than group B(P<0.05);APN in both groups B and C increased After treatment(P<0.05),The APN of group C was slightly higher than that of group B,but the difference of APN was not statistically significant,there was no significant change of APN in group A.Conclusion:Both metformin and Jinlida can increase the level of APN.Jinlida can also reduce insulin resistance,reduce glucose and lipid,and improve the standard rate of blood glucose for T2DM with poor blood glucose and inappropriate use of metformin.