| With the improvement of living standards in recent years,metabolic diseases such as type 2 diabetes,obesity and cardiovascular disease have become important factors threatening human health.The degree of insulin resistance in obese type 2 diabetic patients is significantly higher than that in ordinary diabetic patients.Therefore,it is essential for obese type 2 diabetic patients not only to reduce glucose,but also to reduce insulin resistance and weight loss.As a new hypoglycemic drug,liraglutide has a good effect on weight control and blood glucose control in obese patients with type 2 diabetes.Yang et al.’s 2004 study identified retinol binding protein 4(RBP4)and formalized the relationship between RBP4 and insulin resistance.As an indicator of insulin sensitivity,RBP4 has been mentioned many times in recent years.The purpose of this study was to provide a reference for clinical studies by measuring the changes of serum RBP4 level and insulin resistance degree in patients after 3 months of liraglutide and the influencing factors of the increase of RBP4 level.Objective:The purpose of this study was to determine the changes of serum RBP4 levels in patients before and after 3 months of liraglutide administration,and to analyze the influencing factors of serum RBP4 levels.Methods:Selection of cangzhou people’s hospital endocrine metabolism outpatient and ward overweight and obese patients with type 2 diabetes 30 cases as the research object,collect the patient’s age,body height,body weight,BMI,visceral fat area,TC,TG,HDL-C,LDL-C,FPG,Hb A1 c,CRP and the serum RBP4 levels.the steady-state model are used to calculate indexes of insulin resistance(HOMA IR)= fasting plasma glucose(FPG mmol/L)multiply fasting serum insulin(Fins m U/L)/ 22.5.The above indicators were collected 3 months after administration of liraglutide 1.2mg.After treatment,the levers of body weight,BMI,visceral fat area,TG,FPG,Hb A1 c,FINS,HOMA-IR and serum RBP4 were significantly declined before treatment,and we analyzed the influencing factors of serum RBP4 level.Results:1.General dataA total of 30 patients with T2 DM diagnosed for more than 2 months were enrolled,including 17 males and 13 females,with an age of 46.67±10.24.During the treatment,1 patient developed diarrhea after 2 weeks of medication,and 2 patients stopped the medication spontaneously during the treatment.After treatment,a total of 27 patients were treated,including 16 males and 11 females,with an age of 47.91±11.48.2.Effects of liraglutide on RBP4 and other glucose and lipid metabolism indexesAfter treatment,BMI,TG,FPG,Hb A1 c,FINS,homa-ir,visceral fat area,CRP and RBP4 levels were all lower than before treatment,and the differences were statistically significant(P < 0.05).TG,hdl-c,ldl-c,systolic blood pressure and diastolic blood pressure were not statistically significant(P > 0.05).3.Pair-to-pair correlation analysis between RBP4 and other indicatorsPearson correlation analysis showed that serum RBP4 level was positively correlated with BMI,visceral fat area,TG,FPG,Hb A1 c,HOMA-IR(r=1.828,0.642,0.254,0.625,1.021,0.645,P<0.05),and negatively correlated with HDL-C(r=-0.0.769,P<0.05).4.Multiple linear regression analysis of factors affecting serum RBP4 levelMultiple linear regression analysis was conducted with serum RBP4 level as the dependent variable and BMI,TG,HDL-C,FPG,Hb A1 c,FINS,HOMA-IR,and visceral fat area as the independent variables.The results showed that serum RBP4 level was independently correlated with BMI(β=0.481,P<0.05),visceral fat area(β=0.508,P<0.05)and HOMA-IR(β=0.280,P<0.05).Conclusion:1.Liraglutide can significantly reduce blood glucose,body weight,visceral fat area and lipid metabolism disorders in overweight and obese T2 DM patients.2.Liraglutide can improve IR and reduce serum RBP4 level in overweight and obese T2 DM patients.3.Serum RBP4 level was independently correlated with visceral fat area,HOMA-IR and BMI,suggesting that obesity and increased visceral fat area and insulin resistance may lead to increased serum RBP4 level. |
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