Blood glucose lowering by means of lifestyle intervention has different effects on adipokines as compared with insulin treatment in subjects with type 2 diabetes.
Diabetologia
; 49(5): 872-80, 2006 May.
Article
em En
| MEDLINE
| ID: mdl-16555056
ABSTRACT
AIMS/HYPOTHESIS:
Adipokines may be important in mediating signals from adipocytes to insulin-sensitive tissue and vasculature. We studied the effect of different glucose-lowering therapies on serum levels of plasminogen activator inhibitor-1 (PAI-1), high-sensitivity C-reactive protein (hs-CRP), TNF-alpha, leptin, adiponectin and ghrelin in patients with type 2 diabetes. SUBJECTS ANDMETHODS:
Twenty-eight patients with poorly controlled type 2 diabetes who were receiving oral hypoglycaemic agents were allocated to one of the following groups, and treated for 1 year (1) lifestyle intervention (L); (2) insulin treatment (I); and (3) combined treatment (L+I).RESULTS:
Similar improvements in glycaemic control occurred in all three groups. There was a reduction in body weight of 3.0 kg (median) (95% CI -5.9 to -2.0) in group L, whereas in groups L+I and I body weight increased by 3.5 kg (95% CI 1.5-4.9) and 4.9 kg (95% CI -3.1 to 8.2), respectively. By trend analyses, group L had reduced levels of PAI-1 (p=0.002), hs-CRP (p<0.0001) and TNF-alpha (p=0.006), while no significant changes were observed in the levels of leptin or adiponectin. In group I, the median levels of PAI-1 (p=0.008), TNF-alpha (p=0.058) and leptin (p=0.004) increased. In the L+I group there was a reduction in PAI-1 levels (p=0.014) and an increase in levels of leptin (p<0.001). The differences in changes in the levels of PAI-1, hs-CRP, TNF-alpha and leptin between groups were also significant (all p<0.01). CONCLUSIONS/INTERPRETATION:
Improvement of glycaemic control through lifestyle intervention in type 2 diabetes had more beneficial effects on adipokine levels than when the same lowering of HbA(1c) was achieved with insulin treatment.
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Base de dados:
MEDLINE
Assunto principal:
Oligopeptídeos
/
Ácido Pirrolidonocarboxílico
/
Glicemia
/
Diabetes Mellitus Tipo 2
/
Hormônios de Inseto
/
Estilo de Vida
Tipo de estudo:
Clinical_trials
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2006
Tipo de documento:
Article