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目的探讨预混门冬胰岛素对2型糖尿病(type 2diabetes mellitus,T2DM)患者血浆成纤维细胞生长因子-21(fibroblast growth factor-21,FGF-21)水平的影响。方法 2008年2～12月采用酶联免疫吸附试验测定44例正常人及37例采用预混门冬胰岛素治疗前后的T2DM患者的血浆FGF-21水平,分析血浆FGF-21水平与体质量指数(body mass index,BMI)、体内脂肪百分比(FAT%)、腰臀比、血脂、血糖、糖化血红蛋白(hemoglobin A1c,HbA1c)、游离脂肪酸(free fatty acid,FFA)等的关系。结果治疗前T2DM组患者血浆FGF-21[(1.79±0.04)μg/L]水平明显高于正常对照组[(1.35±0.21)μg/L],差异有统计学意义(P<0.01)。T2DM组经16周预混人胰岛素类似物(BIAsp 50和BIAsp 30)治疗后FFA、HbA1c、空腹血糖、餐后2h血糖均降低(P<0.01),空腹血浆FGF-21水平降低至(1.33±0.39)μg/L,与治疗前比较差异有统计学意义(P<0.01)。相关分析发现T2DM组患者血浆FGF-21水平与BMI呈正相关(r=0.53,P<0.01),BMI是影响T2DM患者血浆FGF-21水平的独立相关因素。结论预混人胰岛素类似物能有效改善T2DM患者代谢紊乱,同时能显著降低FGF-21水平。
Objective To investigate the effect of insulin aspart aspart on the level of fibroblast growth factor-21 (FGF-21) in type 2 diabetes mellitus (T2DM) patients. Methods The plasma levels of FGF-21 in 44 normal subjects and 37 patients with T2DM before and after treatment with insulin aspart asparagine were measured by enzyme-linked immunosorbent assay (ELISA) from January to December in 2008. The levels of plasma FGF-21 and body mass index body mass index (BMI), body fat percentage (FAT%), waist-to-hip ratio, blood lipid, blood glucose, hemoglobin A1c (HbA1c), free fatty acid (FFA) Results The level of plasma FGF-21 [(1.79 ± 0.04) μg / L] in T2DM patients before treatment was significantly higher than that in the normal controls [(1.35 ± 0.21) μg / L, P <0.01). FFA, HbA1c, fasting blood glucose and postprandial blood glucose 2h were lower in T2DM group (P <0.01) and fasting plasma FGF-21 level decreased to (1.33 ± 0.39) μg / L, with statistical significance before treatment (P <0.01). Correlation analysis showed that there was a positive correlation between plasma FGF-21 level and BMI in T2DM patients (r = 0.53, P <0.01). BMI was an independent factor influencing plasma FGF-21 levels in T2DM patients. Conclusion Pre-mixed insulin analogs can effectively improve metabolic disorders in patients with T2DM, while significantly reducing the level of FGF-21.