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目的探讨叶酸干预对2型糖尿病胰岛素抵抗及炎症水平的影响。方法 80例2型糖尿病患者,随机分为干预组和对照组,每组40例。干预组给予叶酸,对照组为未给予叶酸。所有患者干预前采用24 h回顾法进行膳食调查,并在干预前后各采集一次血,检测指标包括空腹血糖(FBG)、血脂、糖化血红蛋白(Hb A1c)、胰岛素含量、胰岛素抵抗指数、血浆叶酸、炎症因子[肿瘤坏死因子、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)],采用t检验和Pearson相关分析。结果 1干预后,干预组血清叶酸水平较干预前明显升高,空腹血糖水平、胰岛素抵抗指数、肿瘤坏死因子-α(TNF-α)、IL-10较干预前降低,IL-10/TNF-α比值升高(P<0.05);干预后两组除空腹胰岛素(FIN)、IL-6外比较差异均有统计学意义(P<0.05)。2糖尿病患者血清叶酸浓度与FBG、Hb A1c、FIN、胰岛素抵抗指数、TNF-α、IL-10呈负相关,与IL-10/TNF-α呈正相关。结论叶酸可以改善2型糖尿病患者炎症反应,改善糖尿病患者胰岛素抵抗,对预防或延缓糖尿病并发症的发生具有潜在的作用。
Objective To investigate the effect of folic acid on insulin resistance and inflammation in type 2 diabetes mellitus (T2DM). Methods 80 patients with type 2 diabetes mellitus were randomly divided into intervention group and control group, 40 cases in each group. The intervention group was given folic acid, and the control group was given no folic acid. All patients underwent a 24-h retrospective dietary survey before and after intervention. Blood glucose, hemoglobin, Hb A1c, insulin, insulin resistance, plasma folate, Inflammatory factors [tumor necrosis factor, interleukin-6 (IL-6), interleukin-10 (IL-10)] were tested using t test and Pearson correlation analysis. Results 1 After intervention, the level of serum folate in the intervention group was significantly higher than that before intervention. The levels of fasting blood glucose, insulin resistance index, tumor necrosis factor-α (TNF-α) and interleukin-10 α ratio (P <0.05). There was significant difference between the two groups except fasting insulin (FIN) and IL-6 (P <0.05) after intervention. The level of serum folate in diabetic patients was negatively correlated with FBG, Hb A1c, FIN, insulin resistance index, TNF-α, IL-10 and positively correlated with IL-10 / TNF-α. Conclusion Folic acid can improve the inflammatory response in type 2 diabetic patients and improve insulin resistance in diabetic patients, which may play a potential role in preventing or delaying the occurrence of diabetic complications.