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目的观察初诊2型糖尿病(T2DM)患者胰岛素强化治疗对血清趋化素(Chemerin)、超敏C反应蛋白(hs-CRP)、胰岛素抵抗指数(HOMA-IR)等的影响。方法选择60例初诊T2DM患者随机分为强化组和对照组,分别进行胰岛素强化和口服药物治疗4周,治疗前后检测血清Chemerin、hs-CRP,同时检测血糖、血脂、胰岛素。结果 (1)强化组及对照组空腹血糖(FPG)、餐后2 h血糖(2h PG)、甘油三酯(TG)、总胆固醇(TC)、hs-CRP治疗后均较治疗前下降(P<0.05)。强化组治疗后FPG、2h PG、hs-CRP较对照组下降(P<0.05)。(2)强化组空腹胰岛素(FINS)、餐后2 h胰岛素(PINS)、胰岛β细胞功能指数(HOMA-β)治疗后较治疗前增高,而HOMA-IR、Chemerin下降(P<0.05);对照组PINS、HOMA-β治疗后较治疗前增高,而HOMA-IR下降(P<0.05)。强化组治疗后PINS、HOMA-β较对照组增高,而HOMA-IR、Chemerin下降(P<0.05)。结论胰岛素强化治疗能减轻炎症,改善胰岛素抵抗,Chemerin在2型糖尿病的亚临床炎症、胰岛素抵抗的病理机制中可能具有重要作用。
Objective To investigate the effects of intensive insulin therapy on serum Chemerin, hs-CRP and HOMA-IR in newly diagnosed type 2 diabetes mellitus (T2DM) patients. Methods Sixty patients with newly diagnosed T2DM were randomly divided into intensive group and control group. Patients were given insulin and oral medication for 4 weeks respectively. Serum Chemerin and hs-CRP levels were measured before and after treatment. Blood glucose, lipids and insulin were measured simultaneously. Results The levels of fasting blood glucose (FPG), postprandial 2h PG, TG, TC and hs-CRP in the intensive group and control group were significantly lower than those before treatment (P <0.05). The levels of FPG, 2h PG and hs-CRP in the intensive group were significantly lower than those in the control group (P <0.05). (2) The levels of fasting insulin (FINS), postprandial 2 h insulin (PINS) and pancreatic β - cell function index (HOMA - β) in treatment group were higher than those before treatment, but decreased in HOMA - IR and Chemerin groups (P <0.05). In the control group, PINS and HOMA-β were higher than those before treatment, while HOMA-IR was decreased (P <0.05). Compared with the control group, the levels of PINS, HOMA-β and HOMA-IR and Chemerin decreased (P <0.05). Conclusion Intensive insulin therapy can reduce inflammation and improve insulin resistance. Chemerin may play an important role in the pathogenesis of subclinical inflammation and insulin resistance in type 2 diabetes mellitus.