2型糖尿病患者血清脂联素水平变化及其与胰岛素抵抗关系的探讨

Studies on serum adiponectin level in patients with type 2 diabetes and its relation to insulin resistance

目的观察2型糖尿病、冠心病患者血清脂联素水平的变化,分析2型糖尿病患者血清脂联素与甘油三酯、体重指数及胰岛素抵抗的关系。方法选取单纯糖尿病患者34例,冠心病患者35例,糖尿病合并冠心病患者30例,健康对照30名作为研究对象,应用放射免疫分析方法测定所有受试者血清脂联素水平,同时测定糖尿病患者及糖尿病合并冠心病患者血清甘油三酯、空腹胰岛素、空腹血糖、体重指数,计算自身稳定型评价胰岛素抵抗(homeostaticmodelassessment-insulinresistance,HOMA-IR)指数。所有计量资料数值以x±s表示,均数之间的差异选用方差分析;各变量之间的关系用直线相关和多元线性回归分析。结果2型糖尿病组[(20±11)滋g/ml]、冠心病组[(18±15)滋g/ml]血清脂联素水平明显低于健康对照组[(37±20)滋g/ml],P值均<0.01;2型糖尿病合并冠心病组血清脂联素水平低于单纯2型糖尿病组[(11±3)滋g/mlvs(29±10)滋g/ml,P<0.01];HOMA-IR指数低于单纯2型糖尿病组[(1.0±0.5)vs(1.3±0.7),P<0.05];2型糖尿病组患者血清脂联素水平与体重指数呈负相关(r=-0.291,P<0.05)、与HOMA-IR指数呈显著负相关(r=-0.473,P<0.01);经多元线性回归分析显示,体内血清脂联素水平只与HOMA-IR指数呈负相关(回归系数=-0.571,P=0.000)。结论2型糖尿病患者、?

Objective To survey the serum level changes of adiponectin in type-2 diabetes and coronary heart diseases (CHD), and analyse the relationship of the diabetes′ serum adiponectin levels with triglycerides (TG), body mass indexes (BMI), and insulin resistance. Methods Thirty-four type 2 diabetic patients and 35 patients with coronary heart disease and 30 type 2 diabetic patients with coronary heart disease and 30 healthy people were investigated. The serum adiponectin level was assayed by RIA. Meanwhile, TG and FINS and BMI were measured, and HOMA-IR index was calculated. Results The levels of serum adiponectin both in type 2 diabetic group and in CHD group were lower than those in control. The level of serum adiponectin in the group which had both type 2 diabetes and CHD was lower than that in type 2 diabetic group [(11±3) μg/ml vs (29±10) μg/ml, P<0.01]; while, the HOMA-IR index was lower in the group which had both type 2 diabetes and CHD than that in the type 2 diabetic group [(1.0±0.5) vs (1.3±0.7), P<0.05]; The serum level of adiponectin in the group of type 2 diabetes showed negative correlation with BMI and significantly negative correlation with HOMA-IR index. Multiple linear regression showed that the level of serum adiponectin only related with HOMA-IR. Conclusion The serum levels of adiponectin both in type 2 diabetic group and in CHD group were significantly decreased. The level of serum adiponectin in the group of type 2 diabetes with CHD is the lowest among the three groups. It is negatively related to HOMA-IR. This suggested that the serum level of adiponectin relate to insulin resistance and macrovascular disease in type 2 diabetic patients.