目的研究长病程肥胖合并2型糖尿病病人接受胰高血糖素样肽-1(GLP-1)治疗前后visfatin的变化,以期探讨GLP-1治疗长病程肥胖合并2型糖尿病的病理生理机制。方法收集2012年3月—2013年9月于黑龙江省医院内分泌科住院肥胖合并2型糖尿病病程10年以上患者50例,接受GLP-1治疗半年,用ELISA方法测定受试者治疗前后血清visfatin水平,并搜集病人血糖、血压、血脂、血清胰岛素、糖化血红蛋白、体质指数、腰臀比等相关指标。分析治疗前后血清visfatin水平及一般指标是否有明显的变化,另取黑龙江省医院体检中心年龄、性别相匹配正常对照组50名,进一步探讨GLP-1治疗长病程肥胖合并2型糖尿病的病理生理机制。结果长病程肥胖合并2型糖尿病患者接受GLP-1治疗半年后visfatin水平较治疗前下降(P<0.01)。治疗后半年回访患者与治疗前自身对照相关指标血糖、血压、血脂、糖化血红蛋白、体质指数、腰臀比显著下降。visfatin和糖化血红蛋白、血清胰岛素、体质指数、低密度胆固醇、空腹血糖均成正相关。结论 visfatin与肥胖合并2型糖尿病密切相关,接受GLP-1治疗半年后visfatin水平明显下降。GLP-1通过抑制餐后胃排空、抑制食欲、促进肝脏、肌肉、脂肪组织糖原合成及刺激胰岛B细胞的增殖和分化、抑制其凋亡等机制发挥作用,通过多靶点治疗长病程的肥胖合并2型糖尿病病人,将有望成为长病程肥胖合并2型糖尿病患者治疗的新靶点。 Objective To investigate the changes of visfatin in patients with long-term obesity and type 2 diabetes treated with GLP-1 before and after treatment with GLP-1 in order to investigate the pathophysiological mechanism of GLP-1 in treating long-term obesity with type 2 diabetes. Methods Fifty patients with obesity and type 2 diabetes mellitus who were admitted to Department of Endocrinology of Heilongjiang Provincial Hospital for more than 10 years from March 2012 to September 2013 were enrolled in the study. Serum visfatin levels were measured by ELISA before and after treatment with GLP-1 , And collected the patient’s blood glucose, blood pressure, blood lipids, serum insulin, glycosylated hemoglobin, body mass index, waist-hip ratio and other related indicators. Analysis of serum visfatin levels before and after treatment and general indicators of whether there are significant changes in the other take the Heilongjiang Provincial Hospital Medical Center age and gender matched 50 normal control group to further explore the GLP-1 treatment of long-term obesity with type 2 diabetes pathophysiology . Results The serum visfatin levels of patients with long-term obesity and type 2 diabetes treated with GLP-1 for six months were lower than those before treatment (P <0.01). After six months of treatment, patients who returned to the control and their own control before treatment indicators related to blood glucose, blood pressure, blood lipids, HbA1c, body mass index, waist-hip ratio decreased significantly. visfatin and glycated hemoglobin, serum insulin, body mass index, low density cholesterol, fasting blood glucose are positively correlated. Conclusions Visfatin is closely related to obesity with type 2 diabetes mellitus. Visfatin levels after 6 months of treatment with GLP-1 are significantly decreased. GLP-1 can inhibit the postprandial gastric emptying, inhibit appetite, promote glycogen synthesis of liver, muscle and adipose tissue, stimulate the proliferation and differentiation of pancreatic islet B cells, inhibit apoptosis and other mechanisms, Of obese patients with type 2 diabetes mellitus are expected to become new targets for the treatment of patients with long-term obesity and type 2 diabetes mellitus.