人GLP-1类似物对2型糖尿病轻度认知功能损害患者血清TNF-α、sICAM-1及sVCAM-1的影响  

Effects of human GLP-1 analogue on serum TNF-α,sVCAM-1 and sICAM-1 levels in patients with type 2 diabetes mellitus and mild cognitive impairment

作　　者：刘璠[1] 杨爱格[1] 贾新菊[1] 王丽娜[1] 康岩[1] 周慧敏[1] 

机构地区：[1]河北医科大学第一医院,河北石家庄050031

出　　处：《现代中西医结合杂志》2016年第35期3880-3882,3980,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：2016年河北省省级科技计划(指令)项目(16277789D)

摘　　要：目的观察人胰升血糖素样肽-1(GLP-1)类似物利拉鲁肽对2型糖尿病轻度认知功能损害(MCI)患者血清肿瘤坏死因子-α(TNF-α)、可溶性细胞间黏附分子-1(s ICAM-1)和可溶性血管细胞黏附分子-1(s VCAM-1)水平的影响,探讨其作用机制。方法选取2型糖尿病MCI患者40例作为实验组,给予利拉鲁肽治疗,疗程12个月;选择同时期健康体检者40例作为对照组。检测对照组及实验组治疗前、治疗6个月及12个月后体质量、收缩压、舒张压、TC、TG、LDL-C、空腹血糖(FBG)、餐后2h血糖(2h PG)、糖化血红蛋白(Hb A1c)、TNF-α、s ICAM-1和s VCAM-1水平。结果治疗前,实验组体质量、FBG、2h PG、Hb A1c、TNF-α、s ICAM-1和s VCAM-1水平均显著高于对照组(P均<0.05),收缩压、舒张压、TC、TG、LDL-C与对照组比较差异均无统计学意义(P均>0.05)。治疗过程中,实验组收缩压、舒张压、TC、TG、LDL-C均无显著变化;治疗6个月及12个月后,实验组体质量、FBG、2h PG、Hb A1c、TNF-α、s ICAM-1和s VCAM-1均显著低于治疗前(P均<0.05),且治疗12个月后s ICAM-1和s VCAM-1水平均明显低于治疗6个月后(P均<0.05);血清TNF-α与s ICAM-1(r=0.831,P<0.05)和s VCAM-1(r=0.434,P<0.05)均呈正相关。结论人GLP-1类似物可能通过降低2型糖尿病MCI患者血清TNF-α水平,进一步抑制血清s ICAM-1和s VCAM-1的作用,预防2型糖尿病并发症的发生、发展。Objective It is to explore its mechanism by observing the changes of serum tumor necrosis factor- ct（TNF - a） , soluble vascular cell adhesion molecule - 1 （ sVCAM - 1 ） and soluble intercellular adhesion molecule - 1 （ slCAM - 1 ） levels in patients with type 2 diabetes mellitus （T2DM） and mild cognitive impairment（MCI） treated by human GLP - 1 ana- logue. Methods Forty patients with T2DM and MCI as experimental group and forty healthy controls were included in the clinical trial. Liraglutide（human GLP-1 analogue） was administrated in the experimental group for 12 months. Body weight, the fasting plasma glucose （FBG）, 2-hour postprandial plasma glucose （2hPG） , Hemoglobin Alc （HbAlc）, TNF-ix, sICAM- 1 and sVCAM - 1 levels were measured before and 6,12 months after the treatment by liraglutide. Results Before the treat-ment, body weight, HbA1c, FBG, 2hPG, TNF -α, sVCAM - 1 and sICAM - 1 in experimental group were significantly higher than those in control group （ all P 〈0. 05 ）. After the treatment, body weight, FBG, 2hPG, HbAlC and TNF -α in experimental group were significantly reduced at the 6th month after treatment and continued to the end of the trial（ P 〈0. 05） , while serum sVCAM - 1 and sICAM - 1 levels gradually reduced （ P 〈 0.05 ）. The level of serum TNF -α was positively correlated with sVCAM - 1 and sICAM - 1 （ rsICAM - 1=0.831, rsVCAM-1=0.434, P 〈 0.05 ）. Conclusion Human GLP - 1 analogue can control the roles of sICAM - 1 and sVCAM - 1 by reducing serum TNF -α level to prevent the development of diabetes complications in patients with T2DM and MCI.

关 键 词：2型糖尿病 人胰升血糖素样肽-1类似物 轻度认知功能损害 肿瘤坏死因子-α 可溶性细胞间黏附分子-1 可溶性血管细胞黏附分子-1 

分 类 号：R587.1[医药卫生—内分泌]