Abstract:

Objective   To investigate the effects of treatment with insulin-sensitizing agents on serum Apelin and tumor necrosis factor-α (TNF-α) levels in obese patients with type 2 diabetes mellitus(T2DM), and to assess the significance of Apelin and TNF-α level changes. Methods   61 newly-diagnosed obese patients with T2DM were enrolled in this study, and they were randomly divided to receive either metformin（the Met group, n=31）or rosiglitazone (the Rog group, n=30) treatment. 30 healthy individuals were included as the normal control group（NC group, n=31). Serum Apelin, TNF-α, fasting blood glucose (FBG), fasting insulin (FIN), glycosylated hemoglobin (HbA1c) and body mass index (BMI) were measured before and after treatment. The insulin resistance index (HOMA-IR) was assessed by a homeostasis model (HOMA). Results    Both serum Apelin and TNF-α levels in obese patients with T2DM were significantly higher than those in the control group, and they were positively correlated with BMI, FIN, FBG and HOMA-IR(P＜0.05). Apelin, TNF-α, FBG and HbA1c significantly decreased after treatment compared to those before treatment（P＜0.05). Moreover,  the Rog group showed lower Apelin and TNF-α levels than those in the Met group（P＜0.05). BMI was significantly decreased in the Met group(P＜0.05) . But had no significant change(P＞0.05) in the Rog group.  Apelin level was positively correlated with TNF-α both before treatment (P＜0.05) and after treatment (P＜0.05). Conclusion   High levels  of serum Apelin and TNFα in obese patients with T2DM may be involved in the occurrence and development of insulin resistance.

Key words: Type 2 diabetes mellitus； Obesity； Apelin； Tumor necrosis factor-α