| Objective:Type 2 diabetes(T2DM)is a kind of chronic life-long disease,which has become the main cause of human health.The traditional treatment aiming at controlling blood glucose can not meet the needs of the society.It has become a new goal to find new treatment strategies and methods,which can not only effectively and continuously antagonize the deteriorating blood glucose control,but also improve the prognosis of complications.1?Nesfatin-1 is a newly discovered factor involved in maintaining glucose homeostasis.However,the relationship between nesfatin-1 and T2DM is still unclear.Although many scholars have studied the relationship between the level of nesfatin-1 in circulation and T2DM,the conclusions are contradictory,and the underlying causes of these contradictory results have not been well described.The purpose of this study was to analyze the expression difference of nesfatin-1 in serum of patients with different glucose tolerance,the correlation between nesfatin-1 and each metabolic index,and to explore the relationship between nesfatin-1 and the occurrence and development of type 2 diabetes.To provide a more early biological index for clinical diagnosis and a better target for the treatment of type 2 diabetes.2?In addition to the increase of blood glucose,the other characteristics of T2DM are systemic low inflammatory state and high oxidative stress,and it plays an important role in the occurrence and development of multi system chronic complications of T2DM.It has become a new direction of treatment of T2DM and its chronic complications to effectively control the inflammatory response in patients and relieve the state of oxidative stress.Nesfatin-1 plays a protective role in maintaining blood glucose homeostasis,which is likely to become a new strategy for the treatment of T2DM.The purpose of this study is to explore the correlation between serum nesfatin-1,inflammatory factors such as IL-6(Interleukin-6),CAT(Catalase)and other oxidative stress indicators in patients with T2DM,so as to provide a new target for the treatment of T2DM and its chronic complications3?Liraglutide is a GLP-1 analogue.It can promote ? cells to secrete insulin,inhibit a cells to secrete glucagon,increase sense of fullness,control energy intake,reduce gastrointestinal peristalsis and prolong gastric emptying time.It has been used in the clinical treatment of T2DM,especially obesity T2DM.The purpose of this study was to investigate the effect of rilalutide on inflammatory indexes such as serum nesfatin-1,IL-6 and oxidative stress indexes such as MDA(Malondialdehyde)in newly diagnosed obese T2DM patients and provide more basis for its clinical application.Methods:1?According to the oral glucose tolerance test(OGTT),60 cases of PreDM group(Prediabetes,PreDM,including IFG and IGT)and 60 cases of T2DM group were enrolled in this study.52 healthy subjects were selected as control group.BMI(Body Mass Index),WHR(Waist-to-Hip Ratio),FPG(Fasting Plasma Glucose),FIns(Fasting Insulin),HbA1c%(Hemoglobin Alc),HOMA-?(Homeostasis model assessment-?,HOMA-?)and nesfatin-1 were measured,and the correlation between nesfatin-1 and BMI,WHR,FPG,HbAlc and HOMA-? was analyzed by Pearson.Taking FPG as the dependent variable,BMI,WHR,FIns and nesfatin-1 as the independent variable,multiple linear regression was used to judge the linear relationship between the independent variable and the dependent variable.2?60 cases of newly diagnosed T2DM and 52 cases of healthy people in physical examination center were selected.We compared the serum levels of IL-6,MCP-1(Monocyte Chemoattractant Protein-1),TNF-?(Tumor Necrosis Factor ?),CAT,superoxide dismutase(SOD),malondialdehyde(MDA)between the two groups,and used Pearson to analyze the correlation between the serum levels of nesfatin-1 and inflammatory factors such as IL-6 and oxidative stress indexes such as CAT among all subjects.3?52 healthy people in the physical examination center were selected as the control group,66 newly diagnosed obese T2DM patients in the outpatient department were selected.BMI,WHR,FPG,FIns,HbA1c%and serum levels of nesfatin-1,IL-6,MCP-1,TNF-?,MDA,CAT and SOD were measured in all subjects.66 obese T2DM patients were randomly divided into the routine treatment group(metformin sustained release tablets+glimepiride tablets)and the liraglutide treatment group.The BMI,WHR,FPG,fins,HbAlc%and serum levels of nesfatin-1,IL-6,MCP-1,TNF-?,MDA,CAT and SOD were measured before and after three months treatment.Results:1?Compared with the healthy control group,BMI,WHR,FPG,Flns,nesfatin-1,HbAlc%of PreDM group increased significantly,HOMA-? decreased significantly(all P<0.05);compared with the healthy control group,BMI,WHR,FPG,FIns,HbAlc%of T2DM group increased significantly,HOMA-?,nesfatin-1 decreased significantly(all P<0.05).Compared with PreDM group,BMI,WHR,FPG,HbAlc%of T2DM group increased significantly,HOMA-?,nesfin-1,FIns decreased significantly(all P<0.05).Of all subjects,there was a positive correlation(P<0.05)between serum nesfatin-1 and WHR,BMI,FIns,HOMA-?,a negative correlation(P<0.05)between nesfatin-1 and FPG,and no significant correlation(P>0.05)between nesfatin-1 and HbAlc.Taking FPG as the dependent variable,BMI,WHR,FIns and nesfatin-1 as the independent variables,using multiple linear regression analysis,it was found that the four independent variables included in the model had statistical influence on FPG(P<0.05).2?Compared with the control group,the serum levels of IL-6,MCP-1,TNF-? and MDA in T2DM group were significantly higher,while the levels of CAT,SOD and nesfatin-1 were significantly lower(all P<0.01).Of all subjects,serum nesfatin-1 was negatively correlated with IL-6,MCP-1,TNF-? and MDA(P<0.01),and positively correlated with CAT and SOD(P<0.01).3?Compared with the healthy control group,FPG,HbAlc%,BMI,WHR,IL-6,MCP-1,TNF-?,MDA in the obese T2DM group were significantly higher(P<0.01),and the levels of nesfatin-1,CAT,SOD in the obese T2DM group were significantly lower(P<0.01).Before the treatment,there was no significant difference between the routine treatment group and the liraglutide treatment group.Compared with the routine treatment group,BMI,HbAlc%,serum IL-6,MCP-1,TNF-?,MDA decreased significantly(P<0.01),while nesfatin-1,CAT,SOD increased significantly(P<0.01)after treatment in liraglutide group.Conclusion:1?Serum nesfatin-1 is one of the factors that affect glucose metabolism.The level of nesfatin-1 has a compensatory increase in the early stage of blood glucose rise,which has a protective effect on maintaining blood glucose homeostasis.However,with the increase of blood glucose and the deterioration of insulin resistance,the level of nesfatin-1 in the patients with diabetes has a decompensated decrease.The decline of nesfatin-1 level is likely to participate in the occurrence and development of type 2 diabetes,its specific mechanism needs further study,and nesfatin-1 is likely to become a new biological index for early diagnosis and treatment of type 2 diabetes2?Nesfatin-1 may be a new therapeutic target to improve the systemic low-grade inflammatory state and relieve the level of oxidative stress in type 2 diabetes mellitus,and thus has potential benefits in the prevention and treatment of chronic complications of diabetes.It deserve our in-depth study3?Liraglutide can not only effectively improve the glucose metabolism of obese T2DM patients,but also up regulate the level of serum nesfatin-1,alleviate the state of inflammation and oxidative stress,which has potential anti-inflammatory and anti oxidative stress effects,and may benefit from the prevention and treatment of chronic complications of diabetes. |
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