胰岛素联合利拉鲁肽对2型糖尿病外周血JNK信号通路的影响

Effect of insulin combined with liraglutide on JNK signaling pathway in peripheral blood in type 2 diabetes

目的 探讨胰岛素联合利拉鲁肽对2型糖尿病(T2DM)外周血c-Jun氨基末端激酶(JNK)信号通路的影响,为临床治疗提供参考。方法 选取2020年4月—2022年8月开封市中心医院收治的60例T2DM患者,以随机数字表法分为观察组、对照组,均30例,对照组给予胰岛素,观察组给予胰岛素联合利拉鲁肽,对比治疗前、治疗3个月后两组糖脂代谢[空腹血糖、餐后2 h血糖、高密度脂蛋白(HDL)、甘油三酯(TG)、低密度脂蛋白(LDL)、总胆固醇(TC)]水平、胰岛素功能[空腹胰岛素(FINS)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]、JNK信号通路相关蛋白表达[转录调控因子(c-Jun)、血红素氧合酶-1(HO-1)]及炎症因子[白介素-1β(IL-1β)、肿瘤坏死因子(TNF-α)、干扰素-γ(IFN-γ)]水平。结果 治疗3个月后与对照组相比,观察组空腹血糖、餐后2 h血糖、TG、LDL、TC较低,HDL水平较高(P<0.05);治疗3个月后与对照组相比,观察组FINS、HOMA-IR水平较低,HOMA-β水平较高(P<0.05);治疗3个月后观察组c-Jun、HO-1表达水平均低于对照组(P<0.05);治疗3个月后观察组炎症因子TNF-α、IL-1β、IFN-γ水平均低于对照组(P<0.05)。结论 胰岛素联合利拉鲁肽可有效改善T2DM患者糖脂代谢状态、胰岛素功能,调节外周血JNK信号通路,减轻患者炎症反应。

Objective To investigate the effect of insulin combined with liraglutide on the peripheral blood c-Jun amino-terminal kinase(JNK) signaling pathway in type 2 diabetes mellitus(T2DM),and to provide reference for clinical treatment.Methods Sixty patients with T2DM admitted to our hospital from April 2020 to August 2022 were selected and divided into observation group(n=30) and control group(n=30) according to the random number table method of 1∶1 matching,in which insulin was given to the control group and insulin combined with liraglutide was given to the observation group,and the two groups were compared before and after 3 months of treatment for glucolipid metabolism [fasting glucose,2 h postprandial glucose,high-density lipoprotein(HDL),triglyceride(TG),low-density lipoprotein(LDL),total cholesterol(TC)] levels,insulin function [fasting insulin(FINS),pancreatic β-cell function index(HOMA-β),insulin resistance index(HOMA-IR)],JNK signaling pathway-related protein expression [transcriptional regulator(c-Jun),heme oxygenase-1(HO-1)] and inflammatory factors [interleukin-1β(IL-1β),tumor necrosis factor(TNF-α),interferon-γ(IFN-γ)] levels.Results After 3 months of treatment,compared with the control group,fasting glucose,2 h postprandial glucose,TG,LDL,TC were lower and HDL levels were higher in the observation group(P<0.05);after 3 months of treatment,the levels of FINS and HOMA-IR were lower and the levels of HOMA-β were higher in the observation group than in the control group(P<0.05);after 3 months of treatment,the expression of c-Jun and HO-1 in the observation group The levels of c-Jun and HO-1 expression in the observation group were lower than those in the control group after 3 months of treatment(P<0.05);the levels of inflammatory factors TNF-α,IL-1β and IFN-γ in the observation group were lower than those in the control group after 3 months of treatment(P<0.05).Conclusion Insulin combined with liraglutide can effectively improve glucolipid metabolic status,insulin function,regulate peripheral blood JNK signaling pathway and reduce inflammatory response in patients with T2DM.