胰岛素强化治疗对2型糖尿病患者血浆GPC-4水平的影响  

Influence of intensive insulin therapy on plasma glypican-4 level in patients with new-onset type 2 diabetes mellitus

作　　者：蒋辉[1] 李钶[2] 阳皓 乐曦[4] 周青梅 刘红娟 黄汉忠 邹菁华 

机构地区：[1]重庆三峡医药高等专科学校附属医院,重庆万州404000 [2]重庆医科大学附属第二医院,400010 [3]重庆市九龙坡区第一人民医院,400050 [4]重庆三峡中心医院,重庆万州404000

出　　处：《检验医学与临床》2014年第17期2384-2386,共3页Laboratory Medicine and Clinic

基　　金：重庆市万州区科委资助项目(wz0105007)

摘　　要：目的探讨胰岛素强化治疗对初诊2型糖尿病(T2DM)患者血浆磷脂酰基醇蛋白聚糖-4(GPC-4)水平的影响及其与胰岛素敏感性的关系。方法随机选择38例初诊T2DM患者(T2DM组),于胰岛素强化治疗前及治疗4周后进行血浆GPC-4水平及其他指标检测,采用高胰岛素-正葡萄糖钳夹术评价患者胰岛素敏感性的变化。以糖耐量正常的体检健康者40例(NGT组)作为对照。结果 T2DM组空腹血浆GPC-4水平为(5.27±1.97)μg/L,低于NGT组[(7.33±2.36)μg/L,P<0.05)]。胰岛素强化治疗后,T2DM组空腹血浆GPC-4水平为(6.42±2.21)μg/L,较治疗前明显升高(P<0.05)。治疗后,T2DM组葡萄糖代谢率明显升高,胰岛素抵抗指数明显降低(P<0.05),且GPC-4水平升高程度与葡萄糖代谢率升高程度呈正相关。结论胰岛素强化治疗不仅可升高初诊T2DM患者血浆GPC-4水平,而且有助于改善患者的胰岛素敏感性;血浆GPC-4水平可能与患者胰岛素敏感性有关。Objective To investigate the influence of intensive insulin therapy on plasma level of glypican-4 （GPC-4） in patients with new-onset type 2 diabetes mellitus （T2DM ） ,and its relationship with insulin sensitivity . Methods A total of 38 patients with new-onset T2DM were enrolled as T2DM group .Plasma GPC-4 and other indi-cators were detected before and 4 weeks after intensive insulin therapy .Euglycemic-hyperinsulinemic clamps were performed to evaluate the insulin sensitivity in all patients .A total of 40 healthy subjects with normal glucose toler-ance （NGT） were enrolled as controls （NGT group） .Results Fasting plasma GPC-4 level was （5 .27 ± 1 .97）μg/L in T2DM group ,which was lower than the （7 .33 ± 2 .36）μg/L in NGT group （P〈0 .05） .Intensive insulin therapy could significantly increase plasma GPC-4 level in T2DM group to （6 .42 ± 2 .21）μg/L （P〈0 .05） ,accompany with increased glucose metabolic rate and decreased insulin resistance index （P〈0 .05） .The elevated plasma GPC-4 level was correlated positively with changes of glucose metabolic rate .Conclusion Intensive insulin therapy could elevate the plasma GPC-4 level and improve insulin sensitivity in patient with new-onset T2DM .GPC-4 might be associated w ith insulin sensitivity in T 2DM patients .

关 键 词：磷脂酰基醇蛋白聚糖-4 2型糖尿病 胰岛素强化治疗 

分 类 号：R587.1[医药卫生—内分泌]