2型糖尿病患者血清抵抗素与血糖、血脂及胰岛素抵抗的关系

The relationship of serum resistin and plasma glucose, lipidemia as well as insulin resistance in type 2 diabetes

目的:探讨2型糖尿病患者血清抵抗素与血糖、血脂及胰岛素抵抗的关系。方法:52例2型糖尿病(T2DM)患者按体质指数(BMI)分为肥胖(BMI≥25kg/m2)(26例)与非肥胖(BMI<25kg/m2)(26例)2组,及17例糖耐量正常的同期健康体检者作为对照组,采用酶联免疫分析法检测空腹血清抵抗素水平;同时行口服葡萄糖耐量(OGTT)和胰岛素释放试验,检测血脂,测量血压、身高、体重、腰围、臀围,计算BMI和腰臀比值(WHR),并以稳态模型(HOMA)计算胰岛素抵抗指数(HOMA-IR)。结果:肥胖T2DM患者血清抵抗素水平(ng/mL)明显高于非肥胖T2DM患者(P<0.01);肥胖T2DM组高于对照组、对照组略高于T2DM非肥胖者,但差异无显著性(P>0.05);女性血清抵抗素水平明显高于男性(P<0.05)。空腹血清抵抗素与BMI、HOMA-IR呈正相关(r=0.403、r=0.337、P<0.001);与FINS及餐后2hINS呈正相关(r=0.652、r=0.428、P<0.001);与甘油三酯呈正相关(r=0.320、P<0.01);与空腹血糖无关而与餐后2h血糖呈负相关(r=-0.303,P<0.05),抵抗素与血压、WHR、年龄、胆固醇、高密度脂蛋白、低密度脂蛋白无明显相关性(P>0.05)。结论:肥胖T2DM患者血清抵抗素水平升高,血清抵抗素与BMI、空腹胰岛素、餐后2h胰岛素、餐后2hPG、HOMA-IR及甘油三酯有关,抵抗素可能参与了肥胖T2DM胰岛素抵抗的形成,并加重T2DM患者甘油三酯异常。

Objective To study the relationship between serum resistin concentrations with type 2 diabetes and plasma glucose , lipidemia as well as insulin resistance. Methods Fasting serum resistin concentration was measured by enzyme immunoassay in 52 cases suffering from T2DM, obesity (BMI≥ 25 kg/m2)(26 subjects) and non- obesity ( BMI< 25 kg/m2)( 26 subjects) were subgrouped on BMI and 17 cases non- diabetic controls with normal glucose tolerance, HOMA- IR were calculated. Meanwhile, OGTT and insulin release test and lipidemia were conducted, blood pressure, height, other data including body weight, waist circumference and hip circumference were measured to calculate BMI and waist- hip ratio (WHR). Results The fasting serum resistin concentration (ng/mL) were higher in obese T2DM than that in those persons with lean T2DM (P< 0.01), in obese T2DM resistin was higher than that in those in non- diabetic group(control group), resistin in control group was slightly higher than normal weight in diabetic group, but difference was not statistical significance( P >0.05) .The fasting resistin was significantly increased in famine.Correlate analysis showed that fasting serum resistin concentration was a positive correlated with BMI, HOMA- IR, fasting insulin, postprandial 2h insulin and triglyceridemia( r=0.403, r=0.337, r=0.652, r=0.428, P< 0.001; r=0.320, P< 0.01). The fasting serum resistin concentration was a negative correlated with postprandial 2h plasma glucose( r= - 0.303, P< 0.05). No correlation between resistin and fasting glucose ,blood pressure, WHR, age, cholesterol, high density lipoprotein, low density lipoprotein were found. Conclusion There are markedly higher in resistin levers in T2DM with obese and fasting serum resistin level was correlated with BMI, FINS, 2h INS, HOMA- IR, 2h PG and TG. Resistin may play a role in the insulin resistance during the developing of obesity to diabetes. Resistin might be result in hypertriglyceridemia.