罗格列酮对2型糖尿病患者血清视黄醇结合蛋白4水平及肝脏脂肪含量的影响  

Effects of rosiglitazone on serum retinol-binding protein 4 and hepatic fat contents in patients with type 2 diabetes mellitus

作　　者：包玉倩[1] 吴海娅[1] 邱慧玲[1] 朱洁华[1] 王韧[2] 贾伟平[1] 

机构地区：[1]上海交通大学附属第六人民医院内分泌代谢科,上海市糖尿病临床医学中心,上海市糖尿病研究所,200233 [2]上海交通大学附属第六人民医院超声医学科

出　　处：《上海医学》2008年第11期767-770,共4页Shanghai Medical Journal

基　　金：上海市科学技术委员会科研计划资助项目(07ZR14060)

摘　　要：目的比较罗格列酮治疗前、后2型糖尿病患者糖脂代谢、视黄醇结合蛋白4(RBP4)和肝脏脂肪含量的变化。方法17例新诊断的2型糖尿病患者,年龄35～69岁,口服罗格列酮4～8mg/d,共24周。治疗前、后及治疗期间,测量体重、腰围、臀围,测定空腹血糖(FPG)、餐后2h血糖(2hPG)、血脂、糖化血红蛋白(HbA1c)、RBP4和脂联素(APN)水平。应用超声直方图技术进行肝脏脂肪含量半定量测定,应用精氨酸刺激试验检测胰岛B细胞功能,以稳态模式评估胰岛素抵抗指数(HOMA-IR)评价患者的胰岛素敏感性。比较治疗前、后上述指标的变化。结果与治疗前比较,罗格列酮治疗后FPG、2hPG、HbA1c和血清RBP4水平显著下降(P值均<0.01),APN水平显著上升(P<0.01);反映肝脏脂肪含量的参数肝脏左叶剑突下纵切、右叶肋间切、右叶肋下斜切及3个切面衰减系数均值较治疗前显著下降(P值均<0.01),降幅分别为19.5%、26.7%、22.0%和22.9%。结论罗格列酮能明显降低2型糖尿病患者的RBP4水平,改善胰岛素抵抗,减少肝脏脂肪含量。Objective To investigate the changes of serum retinol-binding protein 4, hepatic fat content, carbohydrate and lipid metabolism in patients with type 2 diabetes mellitus before and after the treatment with rosiglitazone. Methods Seventeen subjects newly-diagnosed with type 2 diabetes mellitus, aged between 35 to 69 years, were treated with rosiglitazone （4-8 mg/d） for 24 weeks. The wight, waist and hip circumference were measured before and after the rosiglitazone treatment. Fasting plasma glucose （FPG）, 2 hours plasma glucose （2hPG）, HbA1 c, lipid, retinol-binding protein 4 （RBP4） and adiponeetin （APN） were determined at the same time. Hepatic fat content was measured by ultrasound histogram. P^cell function was evaluated by arginine stimulating test, insulin sensitivity was estimated by homeostasis model assessment （HOMA）. The trial adopted a self-controlling methods. Results Compared with baseline levels, the levels of FPG, 2hPG, HbA1c and RBP4 were significantly decreased, and APN level was increased during rosiglitazone treatment （all P〈 0.01）. After treatment, the attenuation coefficients of liver adipose content in the longitudinal section under the xiphoid of left hepatic lobe, the section between the ribs of right hepatic lobe, oblique section under the ribs of right hepatic lobe, and its mean value decreased by 19.50%, 26.7%, 22.0% and 22.9%, respectively. Conclusion Rosiglitazone can decrease serum RBP4 level, reduce the hepatic fat content in patients with type 2 diabetes, and improve insulin resistance.

关 键 词：2型糖尿病 罗格列酮 肝脏脂肪含量 视黄醇结合蛋白4 

分 类 号：R587.1[医药卫生—内分泌]