胰岛素泵对初诊肥胖型2型糖尿病患者抗氧化应激能力、胰岛素抵抗及糖脂代谢的影响
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摘要
目的探究胰岛素泵对初诊肥胖型2型糖尿病(T2DM)患者抗氧化应激能力、胰岛素抵抗及糖脂代谢的影响。方法回顾性分析该院经胰岛素泵治疗(观察组)及经多次胰岛素皮下注射治疗(对照组)的初诊肥胖型T2DM患者各52例临床资料。比较两组治疗前及治疗6个月后超氧化物岐化酶(SOD)、丙二醛(MDA)、稳态模型胰岛素抵抗指数(HOMA-IR)、空腹血糖(FPG)、餐后2h血糖(2hPG)、总胆固醇(TC)、三酰甘油(TG)、C1q/肿瘤坏死因子相关蛋白12(CTRP12)、成纤维细胞生长因子21(FGF21)、摄食抑制因子1(Nesfatin-1)的差异。结果治疗6个月后,两组部分SOD、部分糖脂代谢指标(CTRP12)较治疗前升高(P<0.05),部分氧化应激指标(MDA)、HOMA-IR、FPG、2hPG、TC、TG、FGF21和细胞因子Nesfatin-1则较治疗前降低(P<0.05),且观察组变化幅度大于对照组(P<0.05)。结论胰岛素泵能及时调节初诊肥胖型T2DM患者糖脂代谢,使机体血脂水平趋于稳定,减轻氧化应激反应,并解除胰岛素抵抗作用,促进胰岛β细胞功能逆转,于延缓患者病情进展有积极意义。
Objective To explore the effects of insulin pump on anti-oxidative stress ability,insulin resistance and glycolipid metabolism in patients with newly diagnosed obesity and type 2 diabetes mellitus(T2 DM).Methods The clinical data of 104 patients with newly diagnosed obese T2 DM who were treated with insulin pump(observation group,n=52)and multiple subcutaneous insulin injections(control group,n=52)were retrospectively analyzed.The superoxide dismutase(SOD),malondialdehyde(MDA),homeostasis model assessment of insulin resistance(HOMA-IR),fasting plasma glucose(FPG),postprandial 2 hblood glucose(2 hPG),total cholesterol(TC),triglycerides(TG),C1 q/tumor necrosis factor-related protein 12(CTRP12),fibroblast growth factor 21(FGF21),Nesfatin-1 were compared between the two groups before treatment and after 6 months of treatment.Results After 6 months of treatment,some oxidative stress index(SOD)and some glycolipid metabolism index(CTRP12)in the two groups were higher than those before treatment(P<0.05),and some oxidative stress index(MDA),HOMA-IR,FPG,2 hPG,TC,TG,FGF21 and Nesfatin-1 were lower than those before treatment(P<0.05),and the changes in observation group were greater than those in control group(P<0.05).Conclusion Insulin pump can timely regulate the glycolipid metabolism in patients with newly diagnosed obese T2 DM,make blood lipids levels stable,reduce the oxidative stress response,relieve insulin resistance,and promote the reversal of isletβcell function,and it is of positive significance in delaying the progression of disease.
Objective To explore the effects of insulin pump on anti-oxidative stress ability,insulin resistance and glycolipid metabolism in patients with newly diagnosed obesity and type 2 diabetes mellitus(T2 DM).Methods The clinical data of 104 patients with newly diagnosed obese T2 DM who were treated with insulin pump(observation group,n=52)and multiple subcutaneous insulin injections(control group,n=52)were retrospectively analyzed.The superoxide dismutase(SOD),malondialdehyde(MDA),homeostasis model assessment of insulin resistance(HOMA-IR),fasting plasma glucose(FPG),postprandial 2 hblood glucose(2 hPG),total cholesterol(TC),triglycerides(TG),C1 q/tumor necrosis factor-related protein 12(CTRP12),fibroblast growth factor 21(FGF21),Nesfatin-1 were compared between the two groups before treatment and after 6 months of treatment.Results After 6 months of treatment,some oxidative stress index(SOD)and some glycolipid metabolism index(CTRP12)in the two groups were higher than those before treatment(P<0.05),and some oxidative stress index(MDA),HOMA-IR,FPG,2 hPG,TC,TG,FGF21 and Nesfatin-1 were lower than those before treatment(P<0.05),and the changes in observation group were greater than those in control group(P<0.05).Conclusion Insulin pump can timely regulate the glycolipid metabolism in patients with newly diagnosed obese T2 DM,make blood lipids levels stable,reduce the oxidative stress response,relieve insulin resistance,and promote the reversal of isletβcell function,and it is of positive significance in delaying the progression of disease.
引文
[1]孙英冬,马凯.Ghrelin与肥胖,胰岛素抵抗和2型糖尿病的研究进展[J].中国糖尿病杂志,2017,25(7):666-669.
[2]张天瀛,吕肖锋,张星光,等.胰岛素泵强化治疗对初诊2型糖尿病患者下肢血管病变发生发展的作用[J].解放军医药杂志,2016,28(5):15-19.
[3]王晓敏,孟作龙,赵艳,等.初诊2型糖尿病短期胰岛素泵强化治疗对血清炎症因子及胰岛功能的影响[J].中国医院药学杂志,2016,36(15):1309-1312.
[4]赵炼玲,袁丽.胰岛素泵与每日多次注射胰岛素强化治疗初诊糖尿病患者的疗效观察及护理[J].华西医学,2016,31(10):1758-1760.
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[7]王琳,刘启胜,朱四民,等.利拉鲁肽对Ⅱ型糖尿病伴肥胖患者胰岛β细胞功能和微炎症状态的影响[J].西部医学,2017,29(7):966-969.
[8]田雪品,翟铁,郝凤杰,等.初诊T2DM患者短期胰岛素泵强化治疗后后续治疗方案选择[J].山东医药,2017,57(28):25-27.
[9]周立新,杨晶,孙荃,等.722型和712型胰岛素泵用于初诊2型糖尿病患者的降糖效果和焦虑,抑郁情绪的比较[J].中国糖尿病杂志,2017,9(4):248-250.
[10]张敏,吴晨光,陈小罗,等.肥胖及初诊2型糖尿病患者血清C1补体肿瘤坏死因子相关蛋白12水平变化及相关因素分析[J].中国糖尿病杂志,2016,8(12):763-766.
[11]崔奥媛,李于.成纤维细胞生长因子21的前世今生:胰岛素增敏机制与临床研究[J].中国糖尿病杂志,2017,9(1):18-21.
[12]孙梦丽,卢学勉.成纤维细胞生长因子21与糖尿病性大血管病变[J].中国动脉硬化杂志,2017,25(1):95-98.
[13]赵田,吕肖锋,武晋晓,等.早期胰岛素泵强化治疗对初诊2型糖尿病患者颈动脉粥样硬化进展的影响[J].解放军医药杂志,2016,28(5):5-9.
[14]刘佳,钟成福,张勇.胰岛素泵短期强化治疗对初诊2型糖尿病患者糖脂代谢及胰岛β细胞功能的影响[J].广西医科大学学报,2016,33(6):1018-1021.
[15]王晓光,张薇,任珍,等.短期胰岛素泵强化治疗对初诊2型糖尿病患者糖脂代谢及胰岛β细胞功能的影响[J].川北医学院学报,2017,32(5):768-770.
[16]李云婷,陈丽荣,李诗阳,等.老年糖尿病酮症酸中毒患者外周血氧化应激及炎症指标的改变[J].中国老年学杂志,2017,37(13):3205-3207.
[17]陈宽林,卓铁军,王健,等.沙格列汀对2型糖尿病Nesfatin-1分泌及代谢调节的临床研究[J].中国现代医学杂志,2016,26(13):68-74.
[2]张天瀛,吕肖锋,张星光,等.胰岛素泵强化治疗对初诊2型糖尿病患者下肢血管病变发生发展的作用[J].解放军医药杂志,2016,28(5):15-19.
[3]王晓敏,孟作龙,赵艳,等.初诊2型糖尿病短期胰岛素泵强化治疗对血清炎症因子及胰岛功能的影响[J].中国医院药学杂志,2016,36(15):1309-1312.
[4]赵炼玲,袁丽.胰岛素泵与每日多次注射胰岛素强化治疗初诊糖尿病患者的疗效观察及护理[J].华西医学,2016,31(10):1758-1760.
[5] PAPIER K,D′ESTE C,BAIN C,et al.Body mass index and type 2diabetes in Thai adults:defining risk thresholds and population impacts[J].BMC Public Health,2017,17(1):707.
[6]徐有伟.胰岛素泵强化治疗不同病程初诊2型糖尿病的临床观察及随访研究[J].中国现代医学杂志,2016,26(18):68-74.
[7]王琳,刘启胜,朱四民,等.利拉鲁肽对Ⅱ型糖尿病伴肥胖患者胰岛β细胞功能和微炎症状态的影响[J].西部医学,2017,29(7):966-969.
[8]田雪品,翟铁,郝凤杰,等.初诊T2DM患者短期胰岛素泵强化治疗后后续治疗方案选择[J].山东医药,2017,57(28):25-27.
[9]周立新,杨晶,孙荃,等.722型和712型胰岛素泵用于初诊2型糖尿病患者的降糖效果和焦虑,抑郁情绪的比较[J].中国糖尿病杂志,2017,9(4):248-250.
[10]张敏,吴晨光,陈小罗,等.肥胖及初诊2型糖尿病患者血清C1补体肿瘤坏死因子相关蛋白12水平变化及相关因素分析[J].中国糖尿病杂志,2016,8(12):763-766.
[11]崔奥媛,李于.成纤维细胞生长因子21的前世今生:胰岛素增敏机制与临床研究[J].中国糖尿病杂志,2017,9(1):18-21.
[12]孙梦丽,卢学勉.成纤维细胞生长因子21与糖尿病性大血管病变[J].中国动脉硬化杂志,2017,25(1):95-98.
[13]赵田,吕肖锋,武晋晓,等.早期胰岛素泵强化治疗对初诊2型糖尿病患者颈动脉粥样硬化进展的影响[J].解放军医药杂志,2016,28(5):5-9.
[14]刘佳,钟成福,张勇.胰岛素泵短期强化治疗对初诊2型糖尿病患者糖脂代谢及胰岛β细胞功能的影响[J].广西医科大学学报,2016,33(6):1018-1021.
[15]王晓光,张薇,任珍,等.短期胰岛素泵强化治疗对初诊2型糖尿病患者糖脂代谢及胰岛β细胞功能的影响[J].川北医学院学报,2017,32(5):768-770.
[16]李云婷,陈丽荣,李诗阳,等.老年糖尿病酮症酸中毒患者外周血氧化应激及炎症指标的改变[J].中国老年学杂志,2017,37(13):3205-3207.
[17]陈宽林,卓铁军,王健,等.沙格列汀对2型糖尿病Nesfatin-1分泌及代谢调节的临床研究[J].中国现代医学杂志,2016,26(13):68-74.