【摘要】 目的 探討預混門冬胰島素對2型糖尿?。╰ype 2 diabetes mellitus，T2DM）患者血漿成纖維細胞生長因子-21（fibroblast growth factor-21，F(xiàn)GF-21）水平的影響。 方法 2008年2—12月采用酶聯(lián)免疫吸附試驗測定44例正常人及37例采用預混門冬胰島素治療前后的T2DM患者的血漿FGF-21水平，分析血漿FGF-21水平與體質(zhì)量指數(shù)（body mass index，BMI）、體內(nèi)脂肪百分比（FAT%）、腰臀比、血脂、血糖、糖化血紅蛋白（hemoglobin A1c， HbA1c）、游離脂肪酸（free fatty acid，F(xiàn)FA）等的關系。 結果 治療前T2DM組患者血漿FGF-21[（1.79±0.04） μg/L]水平明顯高于正常對照組[（1.35± 0.21） μg/L]，差異有統(tǒng)計學意義（P lt;0.01）。T2DM組經(jīng)16周預混人胰島素類似物（BIAsp 50和BIAsp 30）治療后FFA、HbA1c、空腹血糖、餐后2 h血糖均降低（P lt;0.01），空腹血漿FGF-21水平降低至（1.33±0.39） μg/L，與治療前比較差異有統(tǒng)計學意義（P lt;0.01）。相關分析發(fā)現(xiàn)T2DM組患者血漿FGF-21水平與BMI呈正相關（r=0.53，P lt;0.01），BMI是影響T2DM患者血漿FGF-21水平的獨立相關因素。 結論 預混人胰島素類似物能有效改善T2DM患者代謝紊亂，同時能顯著降低FGF-21水平。
【Abstract】 Objective To investigate the effects of treatment with aspart insulin on plasma fibroblast growth factor-21 (FGF-21) levels in patients with type 2 diabetes mellitus (T2DM). Methods From February to December 2008, plasma FGF-21 levels were measured by enzyme-linked immunosorbent assay in 37 patients with T2DM treated with aspart insulin and 44 normal controls. The relationship between plasma FGF-21 levels and body mass index (BMI), percentage of body fat (FAT%), waist-hip ratio (WHR), blood lipid, blood glucose, hemoglobin A1c (HbA1c), and free fatty acid (FFA) was analyzed. Results Before treatment, plasma FGF-21 level was significantly higher in T2DM patients [(1.79±0.04) μg/L] than that in the normal controls [(1.35±0.21) μg/L] (P lt;0.01). After 16 weeks of treatment with premixed human insulin analogues (BIAsp 50 and BIAsp 30), FFA, HbA1c, fasting plasma glucose and 2-hour postprandial blood glucose decreased significantly (P lt;0.01), and fasting plasma FGF-21 level decreased to (1.33±0.39) μg/L which was significantly different from that before treatment (P lt;0.01). Correlation analysis showed that plasma FGF-21 level was positively correlated with BMI (r=0.53,P lt;0.01), which was an independent factor in influencing the FGF-21 level in the patients. Conclusion Aspart insulin treatment can remarkably improve glucose metabolism and significantly decrease the fasting plasma FGF-21 level.
引用本文： 曾俊,李伶,楊剛毅,李鈳,李生兵,陳文雯. 預混門冬胰島素強化治療對2型糖尿病患者血漿中成纖維細胞生長因子-21水平的影響. 華西醫(yī)學, 2011, 26(6): 807-810. doi: 復制
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- 1. 閆欣欣, 林灼鋒, 林紹強. 成纖維細胞生長因子21治療代謝性疾病的潛在作用的研究發(fā)展[J]. 中國臨床藥理學雜志, 2010, 12(26): 954-956.
- 2. Nishimura T, Nakatake Y, Konishi M, et al. Identification of a novel FGF, FGF-21, preferentially expressed in the liver[J]. Biochim Biophys Acta, 2000, 1492(1): 203-206.
- 3. Zhang X, Yeung DC, Karpisek M, et al. Serum FGF21 levels are increased in obesity and are independently associated with the metabolic syndrome in humans[J]. Diabetes, 2008, 57(5): 1246-1253.
- 4. Moore DD. Physiology: sister act[J]. Science, 2007, 316(5830): 1436-1438.
- 5. Reitman ML. FGF21: a missing link in the biology of fasting[J]. Cell Metab, 2007, 5(6): 405-407.
- 6. Kharitonenkov A, Shiyanova TL, Koester A, et al. FGF-21 as a novel metabolic regulator[J]. J Clin Invest, 2005, l15(6): 1627-1635.
- 7. Wente W, Efanov AM, Brenner M, et al. Fibroblast growth factor-21 improves pancreaticβ-cell function and survival by activation of extraeellular signal-regulated kinase 1/2 and akt signaling pathways[J]. Diabetes, 2006, 55(9): 2470-2478.
- 8. Kharitonenkov A, Wroblewski VJ, Koester A, et al. The metabolic state of diabetic monkeys is regulated by fibroblast growth factor-21[J]. Endocrinology, 2007, 148(2): 774-781.
- 9. 徐琳, 周博, 孫宏志. 成纖維細胞生長因子21的研究發(fā)展[J]. 醫(yī)學綜述, 2010, 10(16): 2918-2921.
- 10. Radermecker RP, Scheen AJ. Biphasic insulin aspart (Novo Mix 50)[J]. Rev Med Liege, 2008, 63(11): 688-692.