人 GLP －1类似物对2型糖尿病轻度认知功能损害患者血清 TNF －α、sICAM －1及 sVCAM －1的影响

摘要

Obej ctive It is to explore its mechanism by observing the changes of serum tumor necrosis factor -α( TNF-α), soluble vascular cell adhesion molecule -1 (sVCAM-1) and soluble intercellular adhesion molecule -1 (sICAM-1) levels in patients with type 2 diabetes mellitus (T2DM) and mild cognitive impairment(MCI) treated by human GLP-1 ana-logue.Methods Forty patients with T2DM and MCI as experimental group and forty healthy controls were included in the clini-cal trial.Liraglutide(human GLP-1 analogue) was administrated in the experimental group for 12 months.Body weight, the fasting plasma glucose (FBG), 2-hour postprandial plasma glucose (2hPG), Hemoglobin A1c (HbA1c), TNF-α, sICAM-1 and sVCAM-1 levels were measured before and 6,12 months after the treatment by liraglutide .Results Before the treat-ment, body weight, HbA1c,FBG, 2hPG, TNF-α, sVCAM-1 and sICAM-1 in experimental group were significantly high-er than those in control group (all P<0.05).After the treatment, body weight, FBG, 2hPG, HbA1C and TNF-αin experi-mental group were significantly reduced at the 6th month after treatment and continued to the end of the trial (P<0.05), while serum sVCAM-1 and sICAM-1 levels gradually reduced (P<0.05).The level of serum TNF-αwas positively correlated with sVCAM-1 and sICAM-1 (rsICAM-1 =0.831, rsVCAM-1 =0.434,P<0.05).Conclusion Human GLP-1 analogue can control the roles of sICAM -1 and sVCAM-1 by reducing serum TNF-αlevel to prevent the development of diabetes compli-cations in patients with T2DM and MCI.%目的：观察人胰升血糖素样肽－1（ GLP－1）类似物利拉鲁肽对2型糖尿病轻度认知功能损害（ MCI）患者血清肿瘤坏死因子－α（ TNF－α）、可溶性细胞间黏附分子－1（sICAM－1）和可溶性血管细胞黏附分子－1（sVCAM－1）水平的影响，探讨其作用机制。方法选取2型糖尿病MCI患者40例作为实验组，给予利拉鲁肽治疗，疗程12个月；选择同时期健康体检者40例作为对照组。检测对照组及实验组治疗前、治疗6个月及12个月后体质量、收缩压、舒张压、TC、TG、LDL－C、空腹血糖（ FBG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）、TNF －α、sICAM －1和 sVCAM －1水平。结果治疗前，实验组体质量、FBG、2hPG、HbA1c、TNF－α、sICAM－1和sVCAM－1水平均显著高于对照组（P均＜0．05），收缩压、舒张压、TC、TG、LDL－C与对照组比较差异均无统计学意义（ P均＞0．05）。治疗过程中，实验组收缩压、舒张压、TC、TG、LDL－C 均无显著变化；治疗6个月及12个月后，实验组体质量、FBG、2hPG、HbA1c、TNF－α、 sICAM－1和sV-CAM－1均显著低于治疗前（ P均＜0．05），且治疗12个月后sICAM－1和sVCAM －1水平均明显低于治疗6个月后（P均＜0．05）；血清TNF－α与sICAM－1（r ＝08．31，P＜0．05）和sVCAM －1（r＝0．434，P＜0．05）均呈正相关。结论人GLP－1类似物可能通过降低2型糖尿病MCI患者血清TNF－α水平，进一步抑制血清sICAM－1和sVCAM－1的作用，预防2型糖尿病并发症的发生、发展。