去肾交感神经对2型糖尿病大鼠胰岛素抵抗的影响  

Effect of renal denervation on insulin resistance in type 2 diabetic rats

作　　者：何茜[1] 谭洪文 罗建华[1] 于瑞萍[1] 刘波[1] 范元硕[1] 喻日成[1] HE Xi;TAN Hong-wen;LUO Jian-hua;YU Rui-ping;LIU Bo;FAN Yuan-shuo;YU Ri-cheng(Deportment of Endocrinology;b.Department of Cardiology,Guizhou Provincial People＇s Hospital,Guiyang 550002,Guizhou,China)

机构地区：[1]贵州省人民医院内分泌科,贵州贵阳550002 [2]贵州省人民医院心内科,贵州贵阳550002

出　　处：《生物医学工程与临床》2018年第5期511-514,共4页Biomedical Engineering and Clinical Medicine

基　　金：2015年度贵阳市科技计划项目(筑科合同[20151001]社76号)

摘　　要：目的探讨去肾交感神经对2型糖尿病大鼠糖代谢和胰岛素抵抗的影响。方法选择50只健康雄性Wistar大鼠,鼠龄8周龄,体质量180~220 g。随机分成正常组(NO组,n=10)和模型组(n=40)。将模型组大鼠随机分为对照组(DC组)、糖尿病手术组(DO组)、假手术组(DS组),每组11只。检测各组手术前及术后2周、4周、8周空腹血糖(FPG)、空腹胰岛素(FIns)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、肾上腺素(E)、去甲肾上腺素(NE),于术前及术后8周测定糖化血红蛋白(Hb A1c)。以稳态模型评估法评估胰岛素抵抗(HOMA-IR)指数和胰岛β细胞功能(HOMA-β)指数。结果 33只大鼠造模成功,4只造模失败,3只死亡。与术前比较,DO组去肾交感神经术后2周FPG、FIns、hs-CRP、TNF-α、E、NE、HOMA-IR降低,术后4周较术后2周更低(P<0.05);HOMA-β变化与此相反,术后8周与术后4周比较各指标差异均无统计学意义(P>0.05)。DO组术后8周Hb A1c较术前明显下降(6.85±0.55 vs 7.82±0.48;t=3.325,P<0.01),且明显低于相同时间点DS组(7.87±0.78)及DC组(7.90±0.80);DS组及DC组手术前后Hb A1c水平差异无统计学意义(t=1.987、2.102,P>0.05)。结论去肾交感神经可改善胰岛素抵抗,其机制可能与炎症反应的减轻有关。Objective To investigate the effect of renal denervation on glucose metabolism and insulin resistance in type 2 diabetic rats. Methods A total of 50 healthy male Wistar rats were randomly divided into normal group（NO group, n = 10） and model group（n = 40）. The model group was randomly divided into diabetic control group（DC group）, diabetes-operation group（DO group） and diabetes-shame group（DS group）, with 11 rats in each group. The fasting blood glucose（FPG）, fasting insulin（FIns）, hypersensitive C-reactive protein（hs-CRP）, tumor necrosis factor alpha（TNF-α）, epinephrine（E） and norepinephrine（NE） in each group were examined pre-operationally and 2-week, 4-week and 8-week postoperation, and hemoglobin A（1c）（HbA（1c）） was measured before operation and 8-week postoperation. The homeostasis model assessment method was used to e-valuate insulin resistance index（HOMA-IR） and beta cell function index（HOMA-β）. Results Thirty-three rat models were obtained successfully, 4 failed and 3 died. Compared with that of pre-operation, the FPG, FIns, hs-CRP, TNF-α, E, NE,HOMA-IR in DO group after renal sympathetic postoperation 2-week was decreased, and postoperation 4-week was lower than those of 2-week（P〈0.05）, while HOMA-β changed opposite to the above indexes, and there were no significant differences between postoperation 4-week and 8-week（P〉0.05）. Compared with that of pre-operation, the HbA（1c） postoperation 8-week of DO group was significantly decreased（6.85 ± 0.55 vs 7.82 ± 0.48; t = 3.325, P〈0.01）, and which was lower than that of DS group（7.87 ± 0.78） and DC group（7.90 ± 0.80）. There was no significant differences in Hb A1 clevels between DS group and DC group pre-operation and postoperation（t = 1.987, 2.102, P〉0.05）. Conclusion It is demonstrated that renal denervation could decrease insulin resistance, which might contribute to the decline of inflammatory reaction.

关 键 词：去肾交感神经 糖尿病 2型 胰岛素抵抗 大鼠 

分 类 号：R335.6[医药卫生—人体生理学] R587[医药卫生—基础医学]