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胰岛素样生长因子I对2型(非胰岛素依赖型)糖尿病患者血脂谱的改善作用

Improvement of lipid profile in type 2 (non-insulin-dependent) diabetes mellitus by insulin-like growth factor I.

作者信息

Zenobi P D, Holzmann P, Glatz Y, Riesen W F, Froesch E R

机构信息

Department of Internal Medicine, University Hospital, Zurich, Switzerland.

出版信息

Diabetologia. 1993 May;36(5):465-9. doi: 10.1007/BF00402285.

Abstract

Type 2 (non-insulin-dependent) diabetes mellitus is associated with increased glucose, insulin, total and VLDL-triglyceride, and often total and LDL-cholesterol levels which promote vascular disease. Recombinant human insulin-like growth factor-I which mimics many effects of insulin, decreased insulin, total and VLDL-triglyceride, and total and LDL-cholesterol levels in healthy man as well as glucose and insulin levels in Type 2 diabetic patients. We, therefore, investigated total and fractionated triglyceride and cholesterol levels, lipoprotein(a), non-esterified fatty acid, and apolipoprotein levels in eight Type 2 diabetic patients during five control, five treatment, and three wash-out days. They received a constant diet throughout and daily 2 x 120 micrograms insulin-like growth factor-I/kg s.c. during the treatment period. Fasting total and VLDL-triglyceride, total and LDL-cholesterol control levels were (mean +/- SD) 3.1 +/- 2.6, 1.3 +/- 1.0, 6.3 +/- 1.3, and 4.5 +/- 1.1 mmol/l and decreased to 1.6 +/- 0.8, 0.6 +/- 0.4, 5.0 +/- 1.0, and 3.5 +/- 1.1 mmol/l, respectively, on the last treatment day (p < 0.01). During therapy, fasting lipoprotein(a) levels and the postprandial area under the triglyceride curve decreased by 48 +/- 22 and 32 +/- 18% of control (p < 0.01), respectively. In conclusion, insulin-like growth factor-I lowered lipid levels in Type 2 diabetic patients directly or indirectly or both because of decreased glucose and insulin levels. Long-term trials would be of interest with respect to the cardiovascular risk in Type 2 diabetes and patients with hyperlipidaemia.

摘要

2型(非胰岛素依赖型)糖尿病与血糖、胰岛素、总甘油三酯和极低密度脂蛋白甘油三酯水平升高相关,且总胆固醇和低密度脂蛋白胆固醇水平常常升高,这些都会促进血管疾病的发生。重组人胰岛素样生长因子-I模拟胰岛素的多种作用,可降低健康人的胰岛素、总甘油三酯和极低密度脂蛋白甘油三酯水平,以及2型糖尿病患者的血糖和胰岛素水平。因此,我们对8例2型糖尿病患者在5个对照日、5个治疗日和3个洗脱日期间的总甘油三酯和分级甘油三酯及胆固醇水平、脂蛋白(a)、非酯化脂肪酸和载脂蛋白水平进行了研究。他们在整个研究期间饮食保持恒定,在治疗期间每天皮下注射2×120微克胰岛素样生长因子-I/千克体重。空腹总甘油三酯和极低密度脂蛋白甘油三酯、总胆固醇和低密度脂蛋白胆固醇的对照水平(均值±标准差)分别为3.1±2.6、1.3±1.0、6.3±1.3和4.5±1.1毫摩尔/升,在最后一个治疗日分别降至1.6±0.8、0.6±0.4、5.0±1.0和3.5±1.1毫摩尔/升(p<0.01)。在治疗期间,空腹脂蛋白(a)水平和餐后甘油三酯曲线下面积分别下降了对照值的48±22%和32±18%(p<0.01)。总之,胰岛素样生长因子-I直接或间接或两者兼而有之降低了2型糖尿病患者的血脂水平,这是由于血糖和胰岛素水平降低所致。关于2型糖尿病和高脂血症患者的心血管风险,长期试验将很有意义。

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