Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China.
Diabetes Res Clin Pract. 2011 Nov;94(2):186-92. doi: 10.1016/j.diabres.2011.07.036. Epub 2011 Aug 25.
We aimed to assess changes in serum adiponectin and endothelial function after intensive insulin treatment in patients with newly diagnosed type 2 diabetes mellitus (T2DM).
Patients with newly diagnosed T2DM were randomly assigned to Group A (intensive insulin treatment) or Group B (conventional insulin treatment). Before treatment and 2 weeks after plasma glucose concentrations had been maintained at the specified concentrations, blood samples were obtained to measure serum adiponectin and nitric oxide (NO) concentrations. A total of 21 patients were randomized to each Group.
Adiponectin, NO, endothelium-dependent vasodilation (EDD), and endothelium-independent vasodilation (EID) measures were significantly higher post-treatment than pre-treatment in Group A (all P < 0.05). Only EID was significantly higher in Group B (P<0.05). Post-treatment adiponectin and NO concentrations, and EDD were significantly higher in Group A compared with Group B (all P<0.05). Both treatment regimens were well tolerated (all patients completed the study). The most common adverse event was hypoglycemia. Thus, early intensive insulin therapy can increase serum adiponectin and NO concentrations and improve endothelial function in patients with newly diagnosed T2DM.
These effects may underlie the reduced incidence of microvascular and macrovascular in patients who receive early intensive hypoglycemic therapy.
本研究旨在评估新诊断的 2 型糖尿病(T2DM)患者接受强化胰岛素治疗后血清脂联素和内皮功能的变化。
将新诊断的 T2DM 患者随机分为 A 组(强化胰岛素治疗)和 B 组(常规胰岛素治疗)。在维持特定浓度的血浆葡萄糖浓度之前和之后 2 周,采集血样以测量血清脂联素和一氧化氮(NO)浓度。每组随机分配 21 例患者。
A 组治疗后脂联素、NO、内皮依赖性血管舒张(EDD)和内皮非依赖性血管舒张(EID)均明显高于治疗前(均 P<0.05)。B 组仅 EID 明显升高(P<0.05)。与 B 组相比,A 组治疗后脂联素和 NO 浓度以及 EDD 均明显升高(均 P<0.05)。两种治疗方案均耐受良好(所有患者均完成研究)。最常见的不良反应是低血糖。因此,早期强化胰岛素治疗可增加新诊断的 T2DM 患者血清脂联素和 NO 浓度并改善内皮功能。
这些作用可能是接受早期强化降糖治疗的患者微血管和大血管发病率降低的基础。