目的:测定2型糖尿病(T2DM)患者空腹血浆视黄醛结合蛋白-4(RBP-4)浓度,并观察罗格列酮对血浆RBP-4的影响.方法:34例单用二甲双胍降糖治疗效果欠佳的T2DM患者(T2DM组)加用罗格列酮4 mg/d治疗12 wk.30例新近诊断未使用任何降糖药物的初发T2DM患者(nT2DM组).检测nT2DM组及T2DM组治疗前后的体质量指数(BMI)、腰臀比(WHR)、血压、体脂含量(FA)(%)等.采用放免法测定血浆RBP-4水平和胰岛素水平;酶法检测血糖和血脂;高压液相法检测糖基化血红蛋白(HbAlc),计算胰岛素抵抗指数(HO-MA-IR)和分泌指数(HOMA-IS),评价各个代谢指标与血浆RBP-4的相关性.结果:T2DM组RBP-4水平高于nT2DM组[(20.40±0.99)vs(16.94±0.78)mg/L,P＜0.01].罗格列酮治疗后,患者游离脂肪酸(FFA)、HbAlc、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、HOMA-IR(均P＜0.01),空腹胰岛素(Fins)显著降低(P＜0.05).但RBP-4水平变化差异无统计学意义.空腹血浆RBP-4水平与性别(r=0.292,P=0.019)、三酰甘油(TG)(r=0.287,P=0.021)和2 h Pins(r=0.329,P=0.008)显著相关.多元逐步回归分析结果表明,2 h PIns是影响血浆RBP-4水平的独立相关因素.结论:初发T2DM患者RBP-4水平明显低于血糖控制不佳的T2DM患者,罗格列酮治疗可以降低血糖控制不佳T2DM患者血糖,改善胰岛索敏感性,但未明显改变血浆RBP-4水平.
Circulating retinol binding protein-4 in patients with type 2 diabetes and response to rosiglitazone
AIM:To investigate the effects of rosiglitazone treatment on fasting plasma retinol binding protein 4( RBP-4) levels in poor glycemic control patients with type 2 diabetes ( T2DM ). METHODS: Thirty-four type 2 diabetic patients with poor glycemic control on top of ongoing metformin therapy (T2DM group) were treated with rosiglitazone (4 mg/d) for 12 weeks and 30 sex-age- and BMI-matched patients with newly diagnosed T2DM (nT2DM group) were also included in the study. The anthropo-metrical parameters such as body mass index,blood pressure,waist hip radio and fat content were evaluated. Plasma RBP-4 and insulin levels were measured with radioimmunoassay and glucose and lipids were detected by enzymic method. Glycosylated hemoglo-bin(HbA1c) was measured by pressurized liquor chromatography. Homeostatic model assessment of insulin resistance (HOMA-IR) and homeostatic model assessment of insulin secretion (HOMA-IS) were calculated. The relationship between plasma RBP-4 levels and metabolic parameters was also analyzed. RESULTS;The plasma RBP-4 levels were higher in T2DM group than those in nT2DM group[(20.40±0.99) vs (16.94 ±0.78 )mg/L,P<0.01]. The adding of rosiglitazone markedly decreased free fatty acids,HbA1c,fasting plasma glucose,2 h postprandial blood glucose,HOMA-IR(all P < 0. 01) and fasting insulin (P < 0. 05 ),but there were no statistical differences in plasma RBP-4 levels between pre- and post-treatment with rosiglitazone ( P > 0. 05 ). Plasma RBP-4 levels were correlated with sex (r = 0. 292,P = 0. 019),triglyceride( r = 0. 287,P = 0. 021 ) and 2 h postprandial insulin (2 h PIns ) ( r = 0.329,P = 0.008 ). Stepwise multiple regression analysis showed that 2 h PIns was an independent variable of RBP-4. CONCLUSION: The short-term treatment with rosiglitazone decreases blood glucose and insulin resistance but fails to markedly reduce the fasting plasma RBP-4 levels in patients with type 2 diabetes.
NETL
NSTL
万方数据
维普
