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中国男性新诊断2型糖尿病患者接受12个月胰岛素强化治疗后的体重增加及血浆脂联素和瘦素浓度变化

Weight gain and changes in plasma adiponectin and leptin concentrations after 12-month insulin intensive therapy for Chinese male patients with newly diagnosed type 2 diabetes.

作者信息

Zhang Qunhui, Zhao Xiaotong, Chen Mingwei, Fang Zhaohui, Chen Yan, Wang Youmin

机构信息

Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.

Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.

出版信息

Obes Res Clin Pract. 2016 Sep-Oct;10(5):553-563. doi: 10.1016/j.orcp.2015.09.005. Epub 2015 Oct 1.

Abstract

AIM

To examine the effects of intensive insulin therapy (IIT) in Chinese male patients with newly diagnosed type 2 diabetes in 12 months on plasma adiponectin and leptin levels and to assess whether changes in plasma adiponectin and leptin could be associated with subsequent weight gain or not.

METHODS

Overall 84 patients were taken IIT. Total, and high-, and low-molecular-weight (HMW, LMW) adiponectin and leptin concentrations were measured at the time of study inclusion, days 7, and 1, 3, 6 and 12 months after IIT, respectively. Patients' body weight was recorded every time when adiponectin and leptin were measured.

RESULTS

With improvement of diabetes control, plasma total and HMW adiponectin and leptin concentrations increased from inclusion to 3 months significantly and progressively, but remained steady after 6 months. Weight increased relatively modestly with a mean gain of 2kg for 12 months. Moreover, higher increments of total and HMW adiponectin from inclusion to 12 months were associated with significantly less subsequent weight gain after adjustment for confounding factors: the patients in the lowest tertile of total adiponectin increased by 2.47kg compared to patients in the highest tertile who increased by 0.56kg (P-value=0.006). Whereas, the higher increments of leptin levels under the same condition were linked with more subsequent weight gain significantly (P-value=0.003).

CONCLUSIONS

Our researches suggest that glycaemic control with IIT increases total and HMW adiponectin and leptin in newly diagnosed type 2 diabetes male patients, the elevation of total and HMW adiponectin and leptin levels may predict weight gain after IIT.

摘要

目的

探讨强化胰岛素治疗(IIT)对中国新诊断2型糖尿病男性患者12个月血浆脂联素和瘦素水平的影响,并评估血浆脂联素和瘦素的变化是否与随后的体重增加相关。

方法

共84例患者接受IIT治疗。分别在研究纳入时、第7天以及IIT治疗后1、3、6和12个月测定总脂联素、高分子量(HMW)脂联素、低分子量(LMW)脂联素和瘦素浓度。每次测定脂联素和瘦素时记录患者体重。

结果

随着糖尿病控制情况改善,从纳入研究到3个月,血浆总脂联素、HMW脂联素和瘦素浓度显著且逐渐升高,但6个月后保持稳定。体重增加相对适度,12个月平均增加2kg。此外,在调整混杂因素后,从纳入研究到12个月总脂联素和HMW脂联素升高幅度较大与随后体重增加显著较少相关:总脂联素最低三分位数的患者体重增加2.47kg,而最高三分位数的患者体重增加0.56kg(P值=0.006)。然而,在相同条件下瘦素水平升高幅度较大与随后体重增加显著更多相关(P值=0.003)。

结论

我们的研究表明,IIT控制血糖可使新诊断2型糖尿病男性患者的总脂联素、HMW脂联素和瘦素增加,总脂联素、HMW脂联素和瘦素水平的升高可能预测IIT后的体重增加。

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