Effects Of Insulin Reduction On Serum Omentin-1 And Retionl-binding Protein 4 In Patients With Type 2 Diabetes Mellitus

Objective: To investigate the changes of omentin-1 and retinol-binding protein-4(RBP4)in patients with type 2 diabetes mellitus before and after insulin reduction.It is expected that this study will expand a new way to guide the standard dose of insulin in clinical,and hopefully reduce the occurrence of adverse reactions such as hypoglycemia events and weight gain et al,caused by high dose of insulin.Method: A total of 100 type 2 diabetes patients with insulin dose ≥ 40U/day were selected and hospitalized in the first affiliated hospital of Hebei North University during January-December 2019.After excluding the factors affecting omentin-1 and RBP4,the study was enrolled 83 patients,finally.After individualized treatment,insulin dose was reduced and divided into three groups according to insulin decrement gradient(group A: < 60%,group B: 60%-80%,group C: ≥ 80%).Basic information of the 83 patients and relevant blood samples before and after insulin treatment were collected,and respectively compared total samples,intra-group and inter-group.Result:(1)General data comparison: there was no significant difference in age,gender,blood lipid,blood pressure,diabetes course,insulin use time and other indicators between the groups.Body mass index(BMI)decreased in the total samples before and after insulin reduction,as well as in group B and group C(p < 0.05);before insulin reduction,group C was higher than the first two groups,but there was no difference after insulin reduction.(2)Relevant index comparison: Fasting plasma glucose(FPG)and c-peptide(C-P),the model of insulin resistance(HOMA-IR),insulin dose in total samples and contrast in each group have statistically significant before and after reduction.Comparison between the three groups showed only a difference in insulin dose after reduction.(3)Omentin-1 increased in total samples after insulin reduction compared with that before reduction in group B and group C(p > 0.05).There was no difference in the comparison between the three groups before the reduction of insulin,and it showed a gradually increasing trend with the increase of insulin reduction gradient after the insulin reduction(p < 0.05).RBP4 decreased significantly in the total samples and in each group of groups A,B and C before and after the reduction.The RBP4 levels of the three groups were compared before and after insulin reduction,showing no significant difference.(4)Multiple linear regression analysis: Omentin-1 was negatively correlated with insulin dose.RBP4 was positively correlated with HOMA-IR.Conclusion:(1)In this study,the level of omentin-1 decreased with the increase of insulin dose.A modest reduction in insulin dose was associated with an increase in omentin-1 levels.(2)RBP4 increased with the increase of HOMA-IR,and the concentration of RBP4 in circulation could be reduced by adjusting the appropriate insulin treatment regimen to reduce insulin resistance.