摘要
目的研究初诊2型糖尿病合并代谢综合征患者血浆血糖、血清胰岛素水平、血脂、胰岛β细胞功能及血清ghrelin水平的变化。方法同步测定初诊2型糖尿病患者34例,其中合并代谢综合征(MS)患者15例治疗前、治疗后6个月静脉糖耐量试验(IVGTT)时血清、胰岛素、ghrelin、血浆血糖及三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)的水平。结果 (1)治疗后组(DM2)比治疗前组(DM0)胰岛素第一时相分泌、AUC-Ins均明显增加;DM0多点血清ghrelin及ghrelin曲线下面积明显低于DM1(P<0.05)。(2)初诊2型糖尿病合并代谢综合征治疗前组(ADM0)与初诊2型糖尿病未合并代谢综合征治疗前组(BDM0)比较,ADM0组多点胰岛素水平、HOMA-IR、多点血清ghrelin及ghrelin-AUC值均高于BDM0组,差异有统计学意义(P<0.05)。初诊2型糖尿病合并代谢综合征治疗后组(ADM1)多点胰岛素、Ins-AUC分别均高于初诊2型糖尿病未合并代谢综合征治疗后组(BDM1),而ghrelin水平及ghrelin-AUC均分别低于BDM1组,差异均有统计学意义(P<0.05)。(3)多因素相关分析:DM1组空腹血清ghrelin水平与空腹血糖(r=-0.274,P<0.05)、空腹胰岛素(r=-0.350,P<0.05)、BMI呈负相关(r=-0.276,P<0.05),与高密度脂蛋白(r=0.367,P<0.05)呈正相关。结论ghrelin可能参与了2型糖尿病合并代谢综合征的发生和发展。
Objective To investigate the relationship between the response of circulation plasma glucose,insulin, lipid levels and serum ghrelin to therapy and association between β-cell function with metabolic syndrome and newly diagnosed type 2 diabetes mellitus. Methods Total of 34 patients with newly diagnosed type 2 diabetes mellitus at three points was studied. At diagnose before treatment （DM0）, after six months of treatment （DM2）. Intravenous glucose tolerance tests （iVGTT） were performed, and blood glucose, HbAIC , insulin , ghrelin, total cholesterol, LDL-C, HDL-C and tri- glycerides were measured . Insulin sensitivity was assessed by homeostasis model assessment （HO- MA）. of the 34 patients, 15 patients had metabolic syndrome. ResultsCompared with two different groups, beta-cell function was dramatically improved. The mean AUC of insulin was significantly in- creased after treatment （P〈0.05）, ghrelin levels and the mean AUC of ghrelin in DM0 groups were lower （P〈0.05）. Newly diagnosed type 2 diabetes mellitus with metabolic syndrome before treatment （ADM0） had higher levels of fasting serum ghrelin and insulin than did those without metabolic syn- drome （BDM0） （P〈0.05）. Newly diagnosed type 2 diabetes mellitus with metabolic syndrome after treatment （ADM1） had lower levels of fasting serum ghrelin and insulin than did those without meta- bolic syndrome （BDM1） （P〈0.05）. Compared with ADM1 and BDM1, insulin levels and the mean AUCof insulin in BDM1 groups were lower （all P〈 0. 05）. Univariate linear regression analysisshowed that fasting glucose （r= -0. 274, P〈0.05）, fasting insulin （r= -0. 276, P〈0.05）, and body mass index （r=-0. 322, P〈0.05） were negatively correlated with serum ghrelin, and serum highdensity lipoprotein HDL（r= 0. 367, P〈0.05） was positively correlated with serum ghrelin . Conclusion Ghrelin might play an important role in the etiology and progress of metabolic syndrome and newly diagnosed type 2 diabetes mellitus.
出处
《贵州医药》
CAS
2011年第10期867-870,共4页
Guizhou Medical Journal
基金
贵州省科技厅基金资助项目[E2005-9]
