肥胖2型糖尿病患者治疗前后apelin和TNF-α水平变化及其意义  

Significance of Apelin and TNF-α level changes in obese patients with type 2 diabetes mellitus before and after treatment

作　　者：徐华[1] 侯为开[1] 张莉 朱蕾 娄福臣[1] 张莹[1] 王倩[1] 于姗[1] 

机构地区：[1]山东大学齐鲁医院内分泌科,济南250012 [2]山东交通医院内科,济南250031

出　　处：《山东大学学报（医学版）》2010年第3期24-26,38,共4页Journal of Shandong University:Health Sciences

摘　　要：目的探讨初诊肥胖2型糖尿病(T2DM)患者治疗前后血清Apelin与肿瘤坏死因子-α(TNF-α)水平变化及其意义。方法收集初诊肥胖T2DM患者(T2DM组,n=61),随机接受二甲双胍(Met组,n=31)和罗格列酮(Rog组,n=30)治疗,健康体检者为正常对照组(NC组,n=30)。检测治疗前后血清Apelin、TNF-α、空腹血糖(FBG)、空腹胰岛素(FIN)、糖化血红蛋白(HbA1c)水平及体质量指数(BMI)的变化,以稳态模型计算胰岛素抵抗指数(HOMA-IR)。结果肥胖T2DM患者Apelin、TNF-α水平均显著高于NC组(P均<0.05),且与BMI、FIN、FBG、HOMA-IR均呈正相关(P均<0.05);治疗后Apelin、TNF-α、FBG、HbA1c水平均显著下降(P均<0.05),其中Rog组Apelin、TNF-α水平较Met组下降更为显著(P<0.05),Met组BMI显著下降(P<0.05),Rog组无显著变化(P>0.05);相关分析显示治疗前后Apelin与TNF-α均密切相关(P均<0.05)。结论肥胖T2DM患者血清高水平Apelin、TNF-α可能参与胰岛素抵抗的发生发展过程。Objective To investigate the effects of treatment with insulin-sensitizing agents on serum Apelin and tumor necrosis factor-α（TNF-α） levels in obese patients with type 2 diabetes mellitus（T2DM）,and to assess the significance of Apelin and TNF-α level changes.Methods 61 newly-diagnosed obese patients with T2DM were enrolled in this study,and they were randomly divided to receive either metformin（the Met group,n=31）or rosiglitazone（the Rog group,n=30） treatment.30 healthy individuals were included as the normal control group（NC group,n=31）.Serum Apelin,TNF-α,fasting blood glucose（FBG）,fasting insulin（FIN）,glycosylated hemoglobin（HbA1c） and body mass index（BMI） were measured before and after treatment.The insulin resistance index（HOMA-IR） was assessed by a homeostasis model（HOMA）.Results Both serum Apelin and TNF-α levels in obese patients with T2DM were significantly higher than those in the control group,and they were positively correlated with BMI,FIN,FBG and HOMA-IR（P〈0.05）.Apelin,TNF-α,FBG and HbA1c significantly decreased after treatment compared to those before treatment（P〈0.05）.Moreover,the Rog group showed lower Apelin and TNF-α levels than those in the Met group（P〈0.05）.BMI was significantly decreased in the Met group（P〉0.05）.But had no significant change（P〈0.05） in the Rog group.Apelin level was positively correlated with TNF-α both before treatment（P〈0.05） and after treatment（P〈0.05）.Conclusion High levels of serum Apelin and TNF-α in obese patients with T2DM may be involved in the occurrence and development of insulin resistance.

关 键 词：2型糖尿病 肥胖 APELIN 肿瘤坏死因子-Α 

分 类 号：R587.1[医药卫生—内分泌]