摘要
目的:探讨初发2型糖尿病患者(T2DM)外周血白细胞端粒长度变化与胰岛功能的关系。方法:选取本院初发T2DM住院患者,随机分为胰岛素强化治疗组(胰岛素组,99例)和口服药物组(98例),检测并比较患者治疗前后空腹血糖(FBG)、餐后2 h血糖(2h PG)、糖化血红蛋白(GHb A1c),胰岛细胞功能指标包括空腹胰岛素(FINS)及餐后2 h胰岛素(2h INS)水平、β细胞功能稳态模型评估(Homa-β)、胰岛素抵抗指数(Homa-IR)。提取所有患者治疗前后外周血白细胞DNA,采用实时荧光定量PCR测端粒长度,比较治疗前后胰岛β细胞功能变化。70例健康体检者做对照。结果:初发T2DM患者治疗前后对比,两组FPG、2h PG、GHb A1c和Homa-IR显著减低,FINS、2h INS和Homa-β明显增加,但胰岛素组2h INS和Homa-β升高更显著。初发T2DM患者外周血白细胞端粒长度较对照组短,口服药物和强化治疗均能增加端粒长度,以强化治疗为甚,接近对照组水平。以治疗前端粒长度为因变量,以治疗前FPG、FINS、2h INS、GHb A1C、Homa-IR和Homa-β为自变量,进行多元线性回归提示端粒长度仅与治疗前指标中年龄负相关;以治疗前后端粒长度差值为因变量,结果显示Homa-β与治疗前后端粒长度差值呈正相关(r=0.207),即端粒长度延长越明显,Homa-β越高。结论:初发2型糖尿病中胰岛素强化治疗可能是通过增加端粒长度保护β细胞,优于口服降糖药。
Objective To investigate the relationship between telomere length change of peripheral blood leukocyte（ PBL-TL） and β-cell function in patients with newly diagnosed type 2 diabetes mellitus（ T2DM）.Methods Total 197 newly diagnosed hospitalized T2 DM patients were randomly divided into intensive insulin treatment group（ insulin group,n = 99） and oral drug treatment group（ oral group,n = 98）.The levels of fasting blood glucose（ FBG）,2 h postprandial glucose（ 2h PG）,glycosylated hemoglobin（ GHb A1c） and the indexes of islet cell functions including fasting insulin（ FINS）,2 h postprandial insulin（ 2h INS）,HOMA-β,insulin resistance index（ HOMA-IR） were detected and compared between two groups.After isolation of the DNA,PBL-TL from all the patiens,real-time quantitative PCR was used to determine the telomere length.The changes of islet β-cell function was compared before and after treatmnent.Another 70 cases of healthy volunteers were selected as control group.Results After treatment,the levels of FPG,2h PG,GHb A1 c and Homa-IR in all patients were significantly decreased,while the levels of FINS,2h INS and Homa-β were significantly increased,espicially 2h INS and Homa-β in the insulin group. The telomere length of PBL-TL in patients with T2 DM was shorter than that of health control group,but the length was increased in both insulin group and oral group,especially after insulin intensive treatment,the length almost recovered to the control group level in insulin group. When selecting the telomere length before treatment as dependent variable and FPG,FINS,2h INS,GHb A1 C,Homa-IR,Homa-β before treatment as independent variables,the multiple linear regression results demonstrated that telomere length was only negatively correlated with age,but when selecting the difference of telomere length before and after treatment as dependent variable,the change of telomere length was positively correlated with the Homa-β（ r = 0.207）,that was to say,the more elongation the telomere
出处
《湖北医药学院学报》
CAS
2016年第4期362-365,370,共5页
Journal of Hubei University of Medicine
基金
湖北医药学院立项课题(2009QDJ34)
关键词
2型糖尿病
初发
Β细胞功能
端粒长度
强化治疗
Type 2 diabetes
Islet β-cell function
Telomere length
Intensive therapy
