2 型糖尿病患者血浆成纤维细胞生长因子-21 水平的变化及意义

目的:探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血浆成纤维细胞生长因子-21(fibroblast growth factor 21,FGF-21)水平变化以及观察短期胰岛素强化治疗对FGF-21水平的影响。方法:选择我院2013年1月至2015年1月收治的T2DM患者64例,其中初诊T2DM患者32例(T2DM组),T2DM合并大血管病变患者32例(合并大血管病变组),并选择同期体检健康者30例(对照组)。采用酶联免疫法测定三组血浆FGF-21水平以及胰岛素强化治疗前后的变化,分析血浆FGF-21水平与体质量指数(BMI)、腰臀比(WHR)、血脂、血糖、空腹血浆胰岛素(FINS)和糖化血红蛋白(Hb A1C)等水平的关系。结果:T2DM组及T2DM合并大血管病变组患者空腹血浆FGF-21水平明显高于对照组(P0.05),T2DM合并大血管病变组患者空腹血浆FGF-21水平明显高于T2DM组和对照组(P0.05)。空腹血浆FGF-21水平与T2DM患者FPG、Hb A1C水平呈明显正相关,WHR、舒张压、Hb A1C是影响血浆FGF-21水平的独立相关因素。经胰岛素强化治疗后,血浆FGF-21水平较治疗前明显下降(P0.05)。结论:T2DM患者血浆FGF-21水平明显升高,可能参与了T2DM及其大血管病变的发生和发展,胰岛素强化治疗可明显降低T2DM患者血浆FGF-21水平,血浆FGF-21可能作为T2DM病情和疗效评估的参考指标。

Change of Plasma Fibroblast Growth Factor-21 Level of Type 2 Diabetic Patients and its Clinical Significance

Objective:To explore the change of plasma fibroblast growth factor 21 (FGF-21) in type 2 diabetes melli-tus(T2DM) patients with macroangiopathy, and to observe the effect of short-term intensive insulin therapy on FGF-21 level.Methods:Enzyme linked immunosorbent assay (ELISA) was used to detect plasma FGF-21 in 30 healthy controls (control group), 32 patients with newly diagnosed T2DM(T2DMgroup) and 32 T2DMpatients with macroangiopathy (diabetic macroangiopathy group). The change of FGF-21 before and after intensive insulin therapy was observed. The relationship of plasma FGF-21 with body mass index (BMI), waist/hip ratio (WHR), blood lipids, plasma glucose, fast-ing plasma insulin(FIN2) and glycosylated hemoglobin(HbA1C) was analyzed.Results:Plasma level of FGF-21 in T2DM patients with macroangiopathy was increased obviously. The fasting plasma FGF-21 level was positively correlated with FPG and HbA1C. The WHR, diastolic pressure and HbA1C were the independent factors influencing plasma level of FGF-21. Compared with before treatment, plasma level of FGF-21 after intensive insulin therapy was reduced obviously.Conclusion:Plasma FGF-21 may participate in the pathogenesis and development of T 2DM and diabetic macroangiopathy. Short-term intensive insulin therapy can obviously decrease plasma FGF-21 level in T2DMpatients.