title: The significance of tumor necrosis factor-alpha in newly diagnosed type 2 diabetic patients by transient intensive insulin treatment.
abstract: This study was performed to investigate whether transient intensive insulin therapy with an insulin pump (TIIT) can decrease serum tumor necrosis factor-alpha (TNF-alpha) and explore whether the decrease of serum TNF-alpha has correlation with the improvement of islet beta-Cell function and the decrease of insulin resistance. Thirty healthy volunteers served as control subjects. One hundred and thirty-eight newly diagnosed type 2 diabetic patients had been treated with TIIT for 2 weeks. TNF-alpha, free fatty acids (FFAs), glucose, and insulin (INS) had been measured before and after TIIT, respectively. Homeostasis model assessment (HOMA) was used to estimate insulin resistance (HOMA-IR) and islet beta-Cell function (HOMA-beta). TNF-alpha was significantly increased in diabetes. After TIIT, TNF-alpha, fasting blood glucose, FFAs, and HOMA-IR were significantly decreased. HOMA-beta and the areas under the curves of INS were significantly increased during intravenous glucose tolerance tests. TNF-alpha had not only significant negative correlation with the changes of insulin secretion, but also significant positive correlation with the changes of HOMA-IR after adjustment of blood glucose. Partial correlation analyses demonstrated that there was an indepenent relationship between TNF-alpha and HOMA-IR and HOMA-beta. Our study confirms that TIIT can effectively decrease serum TNF-alpha in type 2 diabetes. It is inferred that the decrease of serum TNF-alpha might be involved in the improvement of beta-Cell function and the decrease of insulin resistance by TIIT.
authors.affiliation: Shanghai Diabetic Institute, Shanghai Jiaotong University Affiliated No. 6 People Hospital, 600 Yishan Road, Shanghai 200233, China.
authors.forename: Haibing
authors.initials: H
authors.lastname: Chen
authors.forename: An
authors.initials: A
authors.lastname: Ren
authors.forename: Shilian
authors.initials: S
authors.lastname: Hu
authors.forename: Weilin
authors.initials: W
authors.lastname: Mo
authors.forename: Xuenong
authors.initials: X
authors.lastname: Xin
authors.forename: Weiping
authors.initials: W
authors.lastname: Jia
mesh_terms: D019540:Area Under Curve; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D007333:Insulin Resistance; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D014409:Tumor Necrosis Factor-alpha