摘要
目的探讨短期胰岛素泵强化治疗对2型糖尿病(T2DM)患者血清微小核糖核酸(microRNA,miR)-503和miR-29a表达的影响。方法选取2016年3月至2017年3月收治的118例T2DM患者为研究对象,按照随机分组原则,将其分为治疗组与对照组,每组59例。治疗组给予短期胰岛素泵强化治疗,对照组给予口服降糖药进行治疗。用全自动生化分析仪检测两组治疗前后血糖血脂指标,计算胰岛素分泌指数(HOMA-β)及胰岛素抵抗指数(HOMA-IR),采用实时荧光定量聚合酶链式反应(qRT-PCR)检测血清miR-503和miR-29a mRNA表达水平。结果治疗前,两组血清空腹血糖、糖化血红蛋白(Hb A1c)、餐后2h血糖(2h PG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和HOMA-β、HOMA-IR值及血清miR-503 mRNA、miR-29a mRNA相对表达量比较,差异无统计学意义(P均>0.05)。治疗后,两组各指标较治疗前均明显改善,差异均有统计学意义(P<0.05,P<0.01),且治疗组HOMA-IR值、血清空腹血糖、Hb A1c、2h PG、TG、TC、LDL-C水平和miR-503、miR-29a mRNA相对表达量均低于对照组(P<0.05,P<0.01),HDL-C水平、HOMA-β值均高于对照组(P<0.05,P<0.01)。Spearman秩相关分析示,T2DM患者血清miR-503、miR-29a mRNA表达水平与空腹血糖(r=0.398,r=0.419)、Hb A1c(r=0.596,r=0.531)、2h PG(r=0.370,r=0.421)水平分别呈正相关(P均<0.01),与TG、TC、LDL-C、HDL-C、HOMA-IR、HOMA-β无相关性(P均>0.05);血清miR-503与miR-29a mRNA表达水平呈正相关(r=0.534,P<0.05)。结论短期胰岛素泵强化治疗可显著降低T2DM患者血清miR-503、miR-29a mRNA表达水平,miR-503、miR-29a的表达与T2DM发生发展有关。
Objective To investigate the effects of short-term intensive therapy with insulin pump on serum microRNA(miR)-503 and miR-29 a expressions in patients with type 2 diabetes mellitus(T2 DM). Methods A total of 118 patients with T2 DM between March 2016 and March 2017 were selected as research objects and were divided into treatment group and control group randomly( n = 59 each). Short-term intensive therapy with insulin pump was given in treatment group,and oral hypoglycemic drug was given in control group. Blood glucose and blood lipid indexes were detected with fully automatic biochemical analyser,and insulin secretion function index [homeostasis model assessment( HOMA-β)]and insulin resistance index( HOMA-IR) were calculated. Real-time fluorescence quantitative reverse transcription polymerase chain reaction( qRT-PCR) was used to detect the expression levels of serum miR-503 mRNA and miR-29 amRNA. Results Before treatment,there were no significant differences in fasting serum glucose( FPG),glycosylated hemoglobin( Hb A1 c),postprandial 2 h blood glucose(2 h PG),triglyceride( TG),total cholesterol( TC),high density lipoprotein cholesterol( HDLC),low density lipoprotein cholesterol( LDL-C),HOMA-β,HOMA-IR and the expression levels of serum miR-503 and miR-29 a between two groups( all P > 0. 05). After treatment,aforementioned indexes improved in both two groups( P <0. 05,P < 0. 01),and HOMA-IR,levels of serum FPG,Hb A1 c,2 h PG,TG,TC,LDL-C and relative expression levels of serum miR-503 mRNA and miR-29 a mRNA in treatment group were all lower than those in control group( P < 0. 05,P <0. 01),and HDL-C and HOMA-β in treatment group were all statistically higher than those in control group( P < 0. 05,P <0. 01). Spearman rank correlation analysis showed that serum miR-503 and miR-29 a expression levels were significantly positively correlated with FPG( r = 0. 398,r = 0. 419),Hb A1 c( r = 0. 596,r = 0. 531) and 2 h PG( r = 0. 370,r = 0. 421)( all P < 0. 01) and not significantly correlated with TG,TC,LDL-C,HDL-C,HOMA-IR and HOMA-β( all P > 0. 05),and serum miR-503 mRNA expression level was significantly positively correlated with miR-29 amRNA expression level( r =0. 534,P < 0. 05) in T2 DM patients. Conclusion The short-term intensive therapy with insulin pump can significantly decrease serum miR-503 mRNA and miR-29 a mRNA expression levels in T2 DM patients. The expressions of miR-503 and miR-29 a are related to the occurrece and development of T2 DM.
出处
《中国临床研究》
CAS
2017年第11期1459-1463,共5页
Chinese Journal of Clinical Research
基金
河北省2016年度医学科学研究重点课题计划项目(20160307)
作者简介
通讯作者：郝凤杰，E-mail：haofengjie@medmail．com．cn
