重组赖脯胰岛素治疗糖尿病对IGF-1和IGFBP-1的影响研究

The Effect of Subcutaneous Injection of Recombinant Lispro Insulin on Serum IGF-1 and IGFBP-1 of Patients in the Treatment of Diabetes

目的探讨皮下注射重组赖脯胰岛素治疗糖尿病的疗效及对血清胰岛素样生长因子-1(IGF-1)和胰岛素样生长因子结合蛋白-1(IGFBP-1)的影响。方法选择2018年2月至2020年7月本院门诊收治的152例2型糖尿病患者作为研究对象,在导入期内患者维持原有治疗方案,导入期结束后仍符合入组标准的受试者采用随机数字表法分为观察组(78例)及对照组(74例),随后停用原有降糖方案,观察组在餐前皮下注射国产重组赖脯胰岛素,对照组餐前注射赖脯胰岛素,睡前注射一次甘精胰岛素。检测两组患者血糖、血脂、胰岛素抗体及血浆IGF-1和IGFBP-1水平,评估安全性。结果与治疗前相比,两组患者治疗后糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2hPG)等指标均显著降低(P<0.05),治疗后胰岛素抗体水平升高,各指标两组组间比较差异无统计学意义(P>0.05);两组治疗前后血脂指标比较差异无统计学意义(P>0.05);与治疗前比较,治疗后两组IGFBP-1水平降低(P<0.05),观察组及对照组组间比较差异无统计学意义(P>0.05);观察组及对照组低血糖、总体不良事件发生率比较差异无统计学意义(P>0.05)。结论国产重组赖脯胰岛素控制血糖效果与赖脯胰岛素相当,安全性较高,价格低廉,不失为糖尿病控制血糖的理想选择之一。

Objective To investigate the efficacy of subcutaneous injection of recombinant lispro insulin in the treatment of diabetes and its effect on serum insulin-like growth factor-1(IGF-1)and insulin-like growth factor-binding protein-1(IGFBP-1).Methods A total of 152 patients with type 2 diabetes admitted to the outpatient department of the hospital from February 2018 to July 2020 were selected as the research subjects.During the introduction period,patients maintained the original treatment plan,and subjects who still met the inclusion criteria after the introduction period were divided into the observation group(78 cases)and the control group(74 cases)by the random number table method.Subsequently,the original hypoglycemic regimen was discontinued.The observation group was subcutaneously injected with domestic recombinant lispro insulin before meal,while the control group was injected with lispro insulin before meal,and was injected with insulin glargine once before sleep.Blood glucose,blood lipid,insulin antibody,plasma IGF-1 and IGFBP-1 levels in the two groups were detected to evaluate safety.Results Compared with those before the treatment,glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG),2h postprandial glucose(2hPG)and other indexes in the two groups significantly decreased after the treatment(P<0.05),insulin antibody level increased after the treatment,and there was no statistically significant difference in every index between the two groups(P>0.05).There was no statistically significant difference in blood lipid indexes between the two groups before and after the treatment(P>0.05).Compared with those before the treatment,IGFBP-1 levels in the two groups decreased after the treatment(P<0.05),and there was no statistically significant difference between the observation group and the control group(P>0.05);There was no statistically significant difference in the incidence of hypoglycemia and overall adverse events between the observation group and the control group(P>0.05).Conclusion The effect of domestic recombinant lispro insulin on blood glucose control is similar to that of lispro insulin,with high safety and low price,which can be regarded as one of the ideal choices for controlling blood glucose in patients with diabetes.