二甲双胍治疗对肥胖2型糖尿病患者血清中抵抗素、胰岛素样生长因子Ⅰ水平的影响  

Effect of metformin therapy on serum levels of resistin and insulin-like growth factor-Ⅰ in patients with obese type 2 diabetes

作　　者：徐倩[1] 张方华[1] 许爱梅[1] 王秀秀[1] 姚民秀[1] 

机构地区：[1]青岛大学医学院第二附属医院内分泌科,山东省266042

出　　处：《中华临床医师杂志（电子版）》2013年第13期75-77,共3页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的检测新诊断的肥胖2型糖尿病人群经单用二甲双胍治疗前后抵抗素、胰岛素样生长因子Ⅰ(IGF-Ⅰ)及炎症因子的变化,探讨二甲双胍改善胰岛素抵抗及预防肿瘤发生的分子机制。方法选取新诊断的肥胖2型糖尿病人56例及健康对照50例,经饮食及运动治疗1周后给予二甲双胍1500 mg/d,治疗3个月,给药前后分别抽取空腹静脉血,测定空腹血糖、空腹胰岛素、糖化血红蛋白、抵抗素、IGF-Ⅰ、白细胞介素-6(IL-6)和超敏的C反应蛋白(sCRP),应用稳态模型评估法评价胰岛素抵抗指数(HOMA-IR)。治疗前后的比较及组间的比较采用t检验及单因素方差分析。多因素的分析采用多元回归分析。结果二甲双胍治疗前后空腹血糖、空腹胰岛素、HOMA-IR、糖化血红蛋白、抵抗素、IGF-Ⅰ、IL-6和sCRP明显下降(P<0.05),但仍高于正常对照组(P<0.05)。抵抗素、IL-6和sCRP与胰岛素抵抗指数呈正相关(r=0.95,0.89,0.78,P<0.01),是后者的独立影响因素(β=1.91,0.148,1.6,P=0.000);空腹胰岛素与IGF-Ⅰ呈正相关(r=0.91,P<0.01),是IGF-Ⅰ的独立影响因素(β=4.30,P=0.000)。结论新诊断的肥胖2型糖尿病给予二甲双胍治疗后可能通过降低抵抗素及炎症因子的水平,改善胰岛素抵抗,从而降低了血清胰岛素和IGF-Ⅰ的水平。Objective To investigate molecular mechanisms of metformin improving insulin resistance and preventing carcinogenesis by measuring resistin ,insulin-like growth factor-Ⅰ（ IGF-Ⅰ） and markers of inflammation in newly diagnosed obese type 2 diabetes with metformin therapy .Methods 56 newly diagnosed obese type 2 diabetes who were treated with metformin 1500 mg per day for 3 months after dietary and exercises one week and 50 healthy people as control were selected .Fasting blood glucose ,insulin,hemoglobin A1c,resistin,IGF-Ⅰ,interleukin-6（IL-6）and hypersensitivity C reactive protein （sCRP）were measured.Homeostasis model assessment was used to evaluate the basal insulin resistance （ HOMA-IR ） , t-test and one-way variance analysis were used in the study . Results Fasting blood glucose,insulin,hemoglobin A1c,resistin,IGF-Ⅰ,IL-6,sCRP and HOMA-IR were decreased in type 2 diabetes with metformin 1500 mg per day for 3 months（P〈0.05）,but were higher than in healthy people （P〈0.05）.Resistin,IL-6 and sCRP were positively correlated with HOMA-IR（r=0.95,0.89,0.78,P〈0.01）, which was independent factors of the latter （β=1.91,0.148,1.6,P=0.000）.A significantly positive relationship were shown between fasting blood insulin and IGF-Ⅰ（ r=0.91 ,P〈0.01 ） and the former was independent factors of the latter（β=4.30,P=0.000）.Conclusion Metformin therapy may be possible to reduce the levels of resistin and inflammatory factor in newly diagnosed obesity type 2 diabetes , improve insunlin resistance , thereby decrease the levels of serum insulin and IGF-Ⅰ.

关 键 词：糖尿病 2型 二甲双胍 抵抗素 胰岛素样生长因子Ⅰ 

分 类 号：R587.1[医药卫生—内分泌]