CAJ | 학술논문

目的观察磺脲类(SU)降糖药继发性失效2型糖尿病(T2DM)患者血清瘦素水平,探讨瘦素水平与其他代谢指标的相关性.方法选择60例磺脲类降糖药继发性失效T2DM患者(SFS组)、30例血糖控制良好的T2DM患者(WCP组)和20例健康志愿者(NC组).采用酶联免疫吸附法(ELISA法)检测3组受检者的瘦素水平,同时检测生化指标、胰岛素水平等,并进行相关性分析.结果 WCP组患者血清瘦素水平[(10.2±3.6)ng/ml]与NC组[(6.6±2.3)ng/ml]比较,SFS组患者血清瘦素水平[(14.8±3.9)ng/ml]与WCP组比较,差异均有统计学意义(P＜0.05);WCP组及SFS组患者的空腹胰岛素水平[分别为(16.5±7.2)μU/L和(17.5±7.5)μU/L]、胰岛素抵抗指数(HOMA-IR)[分别为(4.1±2.9)和(4.3±2.9)]与NC组[分别为(13.9±6.8)μU/L和(2.7±1.6)]比较,差异均有统计学意义(P＜0.05).相关性分析显示,SFS组患者血清瘦素水平与空腹血糖、餐后2 h血糖、糖化血红蛋白、体质指数、空腹胰岛素、HOMA-IR、三酰甘油及低密度脂蛋白胆固醇水平呈正相关(P＜0.05),与高密度脂蛋白胆固醇水平呈负相关(P＜0.05).结论瘦素和胰岛素抵抗相互作用,可能在磺脲类降糖药继发性失效发病中起重要作用.
목적 관찰광뇨류(SU)강당약계발성실효2형당뇨병(T2DM)환자혈청수소수평,탐토수소수평여기타대사지표적상관성.방법 선택60례광뇨류강당약계발성실효T2DM환자(SFS조)、30례혈당공제량호적T2DM환자(WCP조)화20례건강지원자(NC조).채용매련면역흡부법(ELISA법)검측3조수검자적수소수평,동시검측생화지표、이도소수평등,병진행상관성분석.결과 WCP조환자혈청수소수평[(10.2±3.6)ng/ml]여NC조[(6.6±2.3)ng/ml]비교,SFS조환자혈청수소수평[(14.8±3.9)ng/ml]여WCP조비교,차이균유통계학의의(P＜0.05);WCP조급SFS조환자적공복이도소수평[분별위(16.5±7.2)μU/L화(17.5±7.5)μU/L]、이도소저항지수(HOMA-IR)[분별위(4.1±2.9)화(4.3±2.9)]여NC조[분별위(13.9±6.8)μU/L화(2.7±1.6)]비교,차이균유통계학의의(P＜0.05).상관성분석현시,SFS조환자혈청수소수평여공복혈당、찬후2 h혈당、당화혈홍단백、체질지수、공복이도소、HOMA-IR、삼선감유급저밀도지단백담고순수평정정상관(P＜0.05),여고밀도지단백담고순수평정부상관(P＜0.05).결론 수소화이도소저항상호작용,가능재광뇨류강당약계발성실효발병중기중요작용.
Objective To investigate the change of serum leptin (LEP) level in type 2 diabetes mellitus (T2DM) patients with secondary failure to sulfonylureas (SFS),and to study the correlativity of the LEP with other metabolic indexes.Methods Sixty T2DM patients with SFS (SFS group) were enrolled,with thirty T2DM patients with good control of blood glucose as WCP group,and twenty health volunteers as NC group.ELISA assay was applied to measure serum LEP level in all subjects,and some biochemical indexes and insulin level were also measured.The correlation analysis was conducted for the results.Results The LEP level in WCP group[(10.2±3.6)ng/ml]was significantly higher than that in NC group[(6.6±2.3)ng/ml] (P＜0.05),and significantly lower than that in SFS group [(14.8±3.9)ng/ml] (P＜0.05).The fasting insulin (FINS)levels in WCP and SFS groups were respectively (16.5±7.2)μU/L and (17.5±7.5)μU/L,higher than (13.9±6.8)μU/L in NC group (P＜0.05).The Homa insulin resistance index (Homa-IR) in WCP and SFS groups were respectively (4.1±2.9) and (4.3±2.9),higher that (2.7±1.6) in NC group (P＜0.05).The correlation analysis showed that SFS patients′ LEP level was positively correlated with fasting blood glucose,2-hour postprandial blood glucose,glycosylated hemoglobin,body mass index,triglyceride,and lower density lipoprotein-cholesterol (P＜0.05); but negatively with high density lipoprotein-cholesterol (P＜0.05).Conclusion The interaction of serum LEP and insulin resistance might play an important role in development of secondary failure to sulfonylureas.