Objective To explore the changes of the serum nesfatin-1 level of type 2 diabetes mellitus (T2DM) patients by short-term intensive insulin treatment, and analyze its relationship with blood glucose, blood lipid, obesity related T2DM. Methods Accord-ing to the BMI, 60 T2DM patients (aged 40-60years old, diagnosed≤5years) with blood glucose uncontrolled(HbA1c≥7%),were di-vided into two groups:T2DM with normal body weight (T2DM-NW group, n=30,BMI < 24kg/m2) and T2DM with obesity (T2DM-OB group, n=30,BMI≥28kg/m2). All subjects accepted two-week intensive insulin therapy. The change and relationship of fasting blood glucose (FPG),2-hour postprandial blood glucose (2hPG), HbA1c, triglyceride (TG), total cholesterol (TC), homa beta cell function index ( HOMA-β) ,insulin resistance index ( HOMA-IR) and the serum nesfatin-1 before and after treatment between two groups were Compared and analyzed. Results The Results showed that the serum nesfatin-1 level in T2DM-NW group was significantly higher than that in T2DM-OB group(P < 0. 05) pre-treatment. After treatment, the FPG, 2hPG, HbA1c, TC, TG,LDL-C, HOMA-IR and serum nesfatin-1 levels of both two groups were decreased dramatically,but body weight, BMI, FIN, HOMA-βwere increased(P < 0. 05). Pear-son correlation analysis showed that the level of serum nesfatin-1 was positively correlated with FPG,2hPG(r value were 0. 295, 0. 257, P < 0. 05),while negatively correlated with body weight, BMI, TG, TC(r value were -0. 641,-0. 770,-0. 507,-0. 543,P < 0. 05);Mul-tiple stepwise linear regression analysis showed that BMI was independently associated with serum nesfatin-1 level ( P < 0. 01 ) . Conclusion The serum nesfatin-1 level can be decreased significantly by short-term intensive insulin treatment. These Results sug-gest that nesfatin-1 may have closely relationship with blood glucose, blood lipid, obesity related T2DM.%目的 观察2型糖尿病患者短期胰岛素强化治疗前后血清nesfatin-1水平的变化,分析血清nesfatin-1水平与血糖、血脂及糖尿病相关肥胖的关系. 方法 60例(年龄40~60岁、病程≤5年)血糖控制不佳( HbA1c≥7%)的2型糖尿病患者按体重指数(BMI)分为糖尿病体重正常组(T2DM-NW组,30例,BMI<24kg/m2)和糖尿病肥胖组(T2DM-OB组,30 例,BMI≥28kg/m2),进行为期2周的胰岛素强化降糖治疗. 比较两组之间及治疗前后空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、血脂、稳态模型评估的胰岛β细胞功能指数(HOMA-β)和胰岛素抵抗指数(HOMA-IR)、血清nesfatin-1水平的变化及相互关系. 结果 胰岛素强化治疗前T2DM-NW组血清nesfatin-1水平显著高于T2DM-OB组(P﹤0. 05);胰岛素强化治疗后,两组FPG、2hPG、HbA1c、TG、TC、LDL-C、HOMA-IR、血清nesfatin-1 水平较治疗前均显著降低(P﹤0. 05),体重、BMI、FIN、HOMA-β较治疗前均升高(P﹤0. 05);Spearman相关分析显示血清nesfatin-1 水平与FPG、2hPG呈正相关(r值分别为0. 295、0. 257,P均<0. 05),而与体重、BMI、TG、TC呈显著负相关(r值分别为-0. 641、-0. 770、-0. 507、-0. 543,P均<0. 05);多元线性回归分析显示BMI为血清nesfatin-1水平的独立影响因素(P<0. 01). 结论 胰岛素强化治疗能显著降低2型糖尿病患者血清nesfatin-1水平,摄食抑制脂肪因子nesfatin-1与血糖、血脂、糖尿病相关性肥胖有密切关联.
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