The Relationship Between C-reactive Protein And Interleukin-6and Insulin Resistance As Well As The Effects Of Repaglinide On Function Of Pancreatic β Cells

Objective To investigate the relationship between the serum concentrations of C reactive protein(CRP), interleukin-6(IL6) and insulin resistance. To discuss the relativity between inflammatory factors and type2diabetes mellitus(T2DM). To investigate the effect of repaglinide on the serum concentrations of C reactive protein(CRP), interleukin-6(IL6). To discuss the anti-inflammatory effect of repaglinide. To investigate the effects of repaglinide on blood glucose and function of pancreatic β cells in newly-diagnosed patients with type2diabetes mellitus. To prove repaglinide has the same effect with insulin on controlling blood glucose and protecting the function of pancreatic β cells.Methods (1) Selecting60newly diagnosed type2diabetes mellitus patients from September2010to June2011, endocrine out-patient clinic and the inpatient department, Jingzhou hospital affiliated tongji medical college of huazhong university of science and technology (in1999WHO diabetes diagnosis and classification standard) for the experimental group. And selecting30cases of normal blood glucose as the control group from the medical examination center, Jingzhou hospital affiliated tongji medical college of huazhong university of science and technology. To measure the serum concentration of CRP and IL-6separately, calculate the homoeostasis model assessment(HOMA-IR) which was evaluated as the insulin resistance index. Independent samples T-test and Pearson correlation analysis were used.(2) Self-control and inter-group control prospective study was conducted in60newly diagnosed type2diabetes mellitus who were randomly divided into two groups after three-month long treatments of repaglinide and insulin. The changes of the serum concentrations of CRP and IL6before and after treatment were analyzed.(3)Self-control and inter-group control prospective study was conducted in60newly diagnosed type2diabetes mellitus who were randomly divided into two groups after three-month long treatments of repaglinide and insulin. The changes of clinical characteristics, biochemical parameters, ΔI30/ΔG30ratio, HOMAβ and HOMA-IR before and after treatment were analyzed.Results (1)The serum concentrations of CRP and IL6with T2DM were obviously higer than those with normal blood glucose (P＜0.01). The CRP level and IL-6level were positively correlated with HOMA-IR(The correlation coefficients are0.921and0.972). (2) The experimental group and the control group both have significant decreasing effect on the serum concentrations of CRP and IL6(all P<0.01). After the treatment, CRP was decreased from6.01±1.36,5.60±1.43mg/L to4.03±1.30,3.70±1.37mg/L. IL-6was decreased from4.97±1.00,4.63±1.40pg/ml to3.60±0.97,3.03±1.13pg/ml. There was no significant difference between the experimental group and the control group(P>0.05).(3)After the treatment,FPG was decreased from10.53±1.20,11.20±1.11to6.32±0.49,6.58±0.30mmol/L,0.5hPG was decreased from12.34±2.32,13.95±2.76to7.42±0.58,7.68±0.60mmol/L,2hPG was decreased from17.67±4.88,20.11±5.04to8.78±0.63,9.03±0.60mmol/L, HbA1c was decreased from8.70±0.89,9.04±0.65to7.11±0.50,7.31±0.61%, and HOMA-IR were significantly decreased, respectively(all P＜.05).0.5hlns was improve from10.50±4.28,9.35±4.94to13.91±5.45,11.52±5.51μIu/mL,ΔI30/ΔG30ratio and HOMA-β were improved too(all P＜0.05).Conclusion The serum concentrations of CRP and IL6with T2DM were obviously higer than those with normal blood glucose, which proved CRP and IL-6have substantial connection with T2DM. And the CRP level and IL-6level were positively correlated with HOMA-IR. The short-term intensive treatment with repaglinide can obviously decrease the the serum concentrations of CRP and IL6at the same time with significantly improve glycemic control, pancreatic β cells function and insulin resistance. Repaglinide can used as an effective and convenient treatment for newly diagnosed type2diabetes mellitus.