Objective To investigate the effects of short-term continuous subcutaneous insulin infusion(CSⅡ) on insulin sensitivity and plasma fibroblast growth factor (FGF)-21 levels in patients with new-onset type 2 diabetes mellitus (T2DM). Methods 30 patients with new-onset T2DM were treated with CSⅡ for 2 w. A hyperinsulinemic-euglycemic clanp was performed for determining insulin sensitivity in T2DM patients. Plasma FGF-21 levels were measured by ELISA. Results The level of FGF-21 was higher in T2DM group than that in control group [ ( 1.6 ±0. 1 ) μg/L vs ( 1. 1 ±0. 4) μg/L, P ＜0.01 ]. After treatment with CSⅡ, the level of FGF-21 was decreased significantly [ ( 1.6 ±0. 1 ) μg/L vs ( 1.3 ± 0. 1 ) μg/L, P ＜ 0. 05 ]. While glucose infusion rate ( GIR ) was increased significantly [ ( 2. 99 ±1.43) mg · kg-1 · min-1 vs. (5. 10±1. 78) mg · kg-1 · min-1 , P ＜0. 01 ]. Conclusions Short-term CSⅡ therapy can remarkably ameliorate insulin sensitivity and degrade plasma FGF-21 level in T2DM patients. The change of plasma FGF-21 level may be related to metabolic disturbance and insulin resistance.%目的 探讨短期胰岛素泵强化治疗对初诊2型糖尿病(T2DM)患者胰岛素敏感性和血浆成纤维细胞生长因子-21(FGF-21)水平的影响.方法 采用自身前后对照,运用高胰岛素-正葡萄糖钳夹术评价30例新诊断T2DM患者接受2 w短期胰岛素泵 (CSII) 强化治疗前后胰岛素敏感性的变化,并采用酶免法测定治疗前后血浆FGF-21水平.结果 T2DM患者血浆FGF-21水平明显高于对照组[(1.6±0.1) vs (1.1±0.4) μg/L,P<0.01].T2DM患者经胰岛素泵强化治疗2 w后,血浆FGF-21水平较治疗前明显下降[(1.6± 0.1) vs (1.3 ± 0.1) μg/L,P<0.05].多元逐步回归分析表明,WHR、2 h PBG、SBP及FFA是影响血浆FGF-21水平的独立相关因素(YFGF-21=0.625XWHR+0.034XPBG+0.003XSBP-0.419XFFA+0.626).结论 短期胰岛素泵强化治疗可明显降低T2DM患者血浆FGF-21水平,血浆FGF-21水平与代谢紊乱有关,并可能参与了T2DM的发生和发展.
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