目的:观察短期胰岛素泵(CSII)强化治疗对初诊2型糖尿病(T2DM)患者血清 Betatrophin 水平的影响,探讨 Betatrophin 与胰岛素抵抗及胰岛β细胞功能的关系。方法:选取60例初诊 T2DM患者接受2周短期 CSII 强化治疗,所有研究对象于治疗前后均行口服葡萄糖耐量试验(OGTT)及胰岛素释放试验,并检测血脂及其他相关生化指标。采用 ELISA 法测定血清 Betatrophin 浓度。结果:CSII 治疗后血清 Betatrophin 水平为448.83(229.89~719.68)pg/mL,较治疗前明显升高[393.79(168.51~577.63)pg/mL,P <0.05]。相关分析结果显示,初诊 T2DM患者 CSII 治疗前血清 Betatrophin 与 HbA1c 呈正相关(r =0.320,P <0.05),与空腹血糖变化量(△Glu 0)、胰岛素抵抗指数变化量(△HOMA-IR)呈负相关(r 分别为-0.304、-0.266,P 均<0.05);CSII 治疗前后血清 Betatrophin 变化量(△Betatrophin)与空腹胰岛素差值(△Ins 0)、空腹 C 肽差值(△C-P 0)呈正相关(r 分别为0.282、0.307,P 均<0.05)。以△Betatrophin 为因变量,△Ins 0、△C-P 0、△Glu 0、△HOMA-IR 为自变量建立多元逐步回归模型,结果显示△C-P 0(β=172.03,P =0.016)进入方程(R2=0.103,P <0.05)。结论:初诊 T2DM患者经短期 CSII 治疗后血清 Betatrophin 水平显著增高;且△C-P 0是△Betatrophin 的独立影响因素。
Objective:To investigate the effect of short-term continuous subcutaneous insulin infusion (CSII)on serum betatrophin in patients with newly diagnosed type 2 diabetes mellitus,and to study the relationships among betatrophin,and IR,pancreatic β-cell function.Methods:Sixty patients with newly diagnosed type 2 diabetes mellitus were treated with CSII for two weeks.Oral glucose tolerance test (OG-TT),insulin releasing test,blood lipid and other relevant items were measured before and after therapy. Serum betatrophin level was determined with ELISA.Results:Two weeks of CSII treatment in T2DMre-sulted in significant elevation in serum betatrophin [393.79 (168.51 -577.63 )pg/mL vs.448.83 (229.89 -719.68),P 〈0.05].Correlation analysis showed that the serum betatrophin before treatment was positively correlated with HbA1c(r =0.320,P 〈0.05),while negatively correlated with △Glu 0 (r =-0.304,P 〈0.05)and △HOMA-IR(r =-0.266,P 〈0.05).The change of serum betatrophin (△Betatrophin)was positively correlated with △Ins 0(r =0.282,P 〈0.05)and △C-P 0(r =0.307, P 〈0.05).Multiple stepwise regression analysis showed that △C-P 0 was the independent influencing factor for the △Betatrophin(β=172.03,P =0.016).Conclusion:The concentration of serum betatro-phin was elevated after two weeks of CSII in newly diagnosed T2DM.The △C-P 0 was the independent related factor in the △Betatrophin.