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  • 預(yù)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

    【摘要】 目的 探討預(yù)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?!》椒ā?008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(yù)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(guān)系。 結(jié)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(xué)意義(Plt;0.01)。T2DM組經(jīng)16周預(yù)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(Plt;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(xué)意義(Plt;0.01)。相關(guān)分析發(fā)現(xiàn)T2DM組患者血漿FGF-21水平與BMI呈正相關(guān)(r=0.53,Plt;0.01),BMI是影響T2DM患者血漿FGF-21水平的獨立相關(guān)因素?!〗Y(jié)論 預(yù)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?!続bstract】 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] (Plt;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 (Plt;0.01), and fasting plasma FGF-21 level decreased to (1.33±0.39) μg/L which was significantly different from that before treatment (Plt;0.01). Correlation analysis showed that plasma FGF-21 level was positively correlated with BMI (r=0.53,Plt;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.

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