胰岛素泵可降低糖尿病患儿血清的HMGB1水平
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摘要
为了探讨胰岛素泵治疗对儿童糖尿病患者血清人高迁移率族蛋白B1 (human high mobility group protein B1, HMGB1)水平的影响,本研究选择1型糖尿病(type 1 diabetes mellitus, T1DM)患儿64例,随机分为胰岛素泵治疗组(观察组)和多次注射胰岛素治疗组(对照组),比较两组糖尿病患儿的空腹血糖(fasting blood glucose, FBG)以及餐后2 h血糖(2 h FBG)、血糖达标时间以及胰岛素用量以及治疗前后的糖化血红蛋白(HbAlc)、C肽和HMGB1水平。结果显示,与对照组比较,观察组的FBG以及2h FBG、血糖达标时间以及胰岛素用量均明显低于对照组,差异均存在统计学意义(p<0.05)。与对照组糖尿病患儿治疗后的结果比较,观察组的HbA1c水平明显降低,C肽含量明显升高,差异均存在统计学意义(p<0.05)。本研究还发现与对照组糖尿病患儿治疗后的结果比较,观察组治疗后的HMGB1水平明显降低,差异均存在统计学意义(p<0.05)。本研究研究结论初步表明,胰岛素泵治疗对儿童糖尿病的改善作用可能与其降低HMGB1水平有关。
To investigate the effect of insulin pump therapy on serum Human High mobility group protein B1(HMGB1) level in children with diabetes mellitus. 64 type 1 diabetes mellitus(T1 DM) patients from June 2017 to October 2018 in our hospital were selected and randomly divided into insulin pump treatment group(observation group) and repeated injections of insulin treatment group(control group). Fasting blood glucose(FBG) and 2 h postprandial blood glucose(FBG), blood glucose therapeutic time, dosage of insulin, glycosylated hemoglobin(HbAlc), C peptide as well as HMGB1 levels between two groups of children with diabetes were compared.Compared with the control group, FBG, 2 h FBG, blood glucose therapeutic time, dosage of insulin in the observation group were significantly lower than those in the control group(p<0.05). Compared with the results of the control group after treatment, the HbA1 c in the observation group after treatment was significantly reduced and c-peptide was significantly increased(all p<0.05). In this study, it was also found that the HMGB1 level in the observation group after treatment was lower than that in the control group after treatment(p<0.05). Our research conclusions preliminarily indicate that the improvement effect of insulin pump on diabetes in children may be related to the decrease in HMGB1 level.
To investigate the effect of insulin pump therapy on serum Human High mobility group protein B1(HMGB1) level in children with diabetes mellitus. 64 type 1 diabetes mellitus(T1 DM) patients from June 2017 to October 2018 in our hospital were selected and randomly divided into insulin pump treatment group(observation group) and repeated injections of insulin treatment group(control group). Fasting blood glucose(FBG) and 2 h postprandial blood glucose(FBG), blood glucose therapeutic time, dosage of insulin, glycosylated hemoglobin(HbAlc), C peptide as well as HMGB1 levels between two groups of children with diabetes were compared.Compared with the control group, FBG, 2 h FBG, blood glucose therapeutic time, dosage of insulin in the observation group were significantly lower than those in the control group(p<0.05). Compared with the results of the control group after treatment, the HbA1 c in the observation group after treatment was significantly reduced and c-peptide was significantly increased(all p<0.05). In this study, it was also found that the HMGB1 level in the observation group after treatment was lower than that in the control group after treatment(p<0.05). Our research conclusions preliminarily indicate that the improvement effect of insulin pump on diabetes in children may be related to the decrease in HMGB1 level.
引文
Chehregosh a H.,Khamseh M.E.,Malek M.,Hosseinpanah F.,and Ismail-Beigi F.,2019,A view beyond HbA1c:role of continuous glucose monitoring,Diabetes Ther.,10(3):853-863
Cjdn C.J.D.N.,and Alves C.A.D.,2018,Influence of socioeconomic and psychological factors in glycemic control in young children with type 1 diabetes mellitus,J.Pediatr.,95(1):48-53
Condren M.,Sabet S.,Chalmers L.J.,Saley T.,and Hopwood J.,2019,Technology for augmenting type 1 diabetes mellitus management,J.Pediatr.Pharmacol.Ther.,24(2):99-106
Han J.,Zhong J.,Wei W.,Wang Y.,Huang Y.,Yang P.,Purohit S.,Dong Z.,Wang M.H.,She J.X.,Gong F.,Stern D.M.,and Wang C.Y.,2008,Extracellular high-mobility group box 1acts as an innate immune mediator to enhance autoimmune progression and diabetes onset in NOD mice,Diabetes,57(8):2118-2127
Hosokawa Y.,Kozaw a J.,Nishizawa H.,Kawamori D.,Maeda N.,Otsuki M.,Matsuoka T.A.,Iwahashi H.,and Shimomura I.,2019,Positive correlation between fasting plasma glucagon and serum C-peptide in Japanese patients with diabetes,Heliyon,5(5):e01715
Jin X.,Rong S.,Yuan W.,Gu L.,Jia J.,Wang L.,Yu H.,and Zhuge Y.,2018,High mobility group Box 1 promotes aortic calcification in chronic kidney disease via the Wnt/beta-Catenin pathway,Front Physiol.,9:665
Marjanac I.,Lovric R.,and Barbic J.,2019,Serum levels of the high-mobility group box 1 protein(HMGB1)in children with type 1 diabetes mellitus:case-control study,Cent.Eur.J.Immunol.,44(1):33-37
Mazur A.,Matusik P.,Revert K.,Nyankovskyy S.,Socha P.,Binkowska-Bury M.,Grzegorczyk J.,Caroli M.,Hassink S.,Telega G.,and Malecka-Tendera E.,2013,Childhood obesity:Knowledge,attitudes,and practices of European pediatric care providers,Pediatrics,132(1):e100-e108
Mueller-Godeffroy E.,Vonthein R.,Ludwig-Seibold C.,Heidtmann B.,Boettcher C.,Kramer M.,Hessler N.,Hilgard D.,Lilienthal E.,Ziegler A.,Wagner V.M.,and German Working Group for Pediatric Pump Therapy,2018,Psychosocial benefits of insulin pump therapy in children with diabetes type 1 and their families:The pumpkin multicenter randomized controlled trial,Pediatr Diabetes.,19(8):1471-180
Pickup J.C.,2019,Is insulin pump therapy effective in Type 1 diabetes?Diabet.Med.,36(3):269-278
Pickup J.C.,and Sutton A.J.,2008,Severe hypoglycaemia and glycaemic control in Type 1 diabetes:Meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion,Diabet.Med.,25(7):765-774
Rewers M.,2012,Challenges in diagnosing type 1 diabetes in different populations,Diabetes Metab.J.,36(2):90-97
Ross L.J.,and Neville K.A.,2019,Continuous subcutaneous insulin infusion versus multiple daily injections for type 1 diabetes,J.Paediatr.Child.Health,55(6):718-722
Streisand R.,and Monaghan M.,2014,Young children with type1 diabetes:challenges,research,and future directions,Curr.Diab.Rep.,14(9):520
Venereau E.,De Leo F.,Mezzapelle R.,Careccia G.,Musco G.,and Bianchi M.E.,2016,HMGB1 as biomarker and drug target,Pharmacol.Res.,111:534-544
Wang Y.,Zhong J.,Zhang X.,Liu Z.,Yang Y.,Gong Q.,and Ren B.,2016,The role of HMGB1 in the pathogenesis of type 2 diabetes,J.Diabetes.Res.,2016:2543268
Yeh H.C.,Brown T.T.,Maruthur N.,Ranasinghe P.,Berger Z.,Suh Y.D.,Wilson L.M.,Haberl E.B.,Brick J.,Bass E.B.,and Golden S.H.,2012,Comparative effectiveness and safety of methods of insulin delivery and glucose monitoring for diabetes mellitus:A systematic review and meta-analysis,Ann.Intern.Med.,157(5):336-347
Cjdn C.J.D.N.,and Alves C.A.D.,2018,Influence of socioeconomic and psychological factors in glycemic control in young children with type 1 diabetes mellitus,J.Pediatr.,95(1):48-53
Condren M.,Sabet S.,Chalmers L.J.,Saley T.,and Hopwood J.,2019,Technology for augmenting type 1 diabetes mellitus management,J.Pediatr.Pharmacol.Ther.,24(2):99-106
Han J.,Zhong J.,Wei W.,Wang Y.,Huang Y.,Yang P.,Purohit S.,Dong Z.,Wang M.H.,She J.X.,Gong F.,Stern D.M.,and Wang C.Y.,2008,Extracellular high-mobility group box 1acts as an innate immune mediator to enhance autoimmune progression and diabetes onset in NOD mice,Diabetes,57(8):2118-2127
Hosokawa Y.,Kozaw a J.,Nishizawa H.,Kawamori D.,Maeda N.,Otsuki M.,Matsuoka T.A.,Iwahashi H.,and Shimomura I.,2019,Positive correlation between fasting plasma glucagon and serum C-peptide in Japanese patients with diabetes,Heliyon,5(5):e01715
Jin X.,Rong S.,Yuan W.,Gu L.,Jia J.,Wang L.,Yu H.,and Zhuge Y.,2018,High mobility group Box 1 promotes aortic calcification in chronic kidney disease via the Wnt/beta-Catenin pathway,Front Physiol.,9:665
Marjanac I.,Lovric R.,and Barbic J.,2019,Serum levels of the high-mobility group box 1 protein(HMGB1)in children with type 1 diabetes mellitus:case-control study,Cent.Eur.J.Immunol.,44(1):33-37
Mazur A.,Matusik P.,Revert K.,Nyankovskyy S.,Socha P.,Binkowska-Bury M.,Grzegorczyk J.,Caroli M.,Hassink S.,Telega G.,and Malecka-Tendera E.,2013,Childhood obesity:Knowledge,attitudes,and practices of European pediatric care providers,Pediatrics,132(1):e100-e108
Mueller-Godeffroy E.,Vonthein R.,Ludwig-Seibold C.,Heidtmann B.,Boettcher C.,Kramer M.,Hessler N.,Hilgard D.,Lilienthal E.,Ziegler A.,Wagner V.M.,and German Working Group for Pediatric Pump Therapy,2018,Psychosocial benefits of insulin pump therapy in children with diabetes type 1 and their families:The pumpkin multicenter randomized controlled trial,Pediatr Diabetes.,19(8):1471-180
Pickup J.C.,2019,Is insulin pump therapy effective in Type 1 diabetes?Diabet.Med.,36(3):269-278
Pickup J.C.,and Sutton A.J.,2008,Severe hypoglycaemia and glycaemic control in Type 1 diabetes:Meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion,Diabet.Med.,25(7):765-774
Rewers M.,2012,Challenges in diagnosing type 1 diabetes in different populations,Diabetes Metab.J.,36(2):90-97
Ross L.J.,and Neville K.A.,2019,Continuous subcutaneous insulin infusion versus multiple daily injections for type 1 diabetes,J.Paediatr.Child.Health,55(6):718-722
Streisand R.,and Monaghan M.,2014,Young children with type1 diabetes:challenges,research,and future directions,Curr.Diab.Rep.,14(9):520
Venereau E.,De Leo F.,Mezzapelle R.,Careccia G.,Musco G.,and Bianchi M.E.,2016,HMGB1 as biomarker and drug target,Pharmacol.Res.,111:534-544
Wang Y.,Zhong J.,Zhang X.,Liu Z.,Yang Y.,Gong Q.,and Ren B.,2016,The role of HMGB1 in the pathogenesis of type 2 diabetes,J.Diabetes.Res.,2016:2543268
Yeh H.C.,Brown T.T.,Maruthur N.,Ranasinghe P.,Berger Z.,Suh Y.D.,Wilson L.M.,Haberl E.B.,Brick J.,Bass E.B.,and Golden S.H.,2012,Comparative effectiveness and safety of methods of insulin delivery and glucose monitoring for diabetes mellitus:A systematic review and meta-analysis,Ann.Intern.Med.,157(5):336-347
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