2型糖尿病患者正常糖耐量一级亲属胰岛素抵抗的研究

Insulin receptors in normal glucose tolerant first-degree relatives of type 2 diabetic patients

[目的]探讨2型糖尿病患者正常糖耐量一级亲属(NFDR)与血清脂联素、瘦素及红细胞膜胰岛素受体的相关性。[方法]测定NFDR60例、正常人40例(对照组),空腹血糖、胰岛素、脂联素、瘦素、高、低亲和力红细胞膜胰岛素受体数目(R1、R2)和亲和力常数(K1、K2)及血脂,并测定餐后2 h血糖(PBG)及胰岛素(P2hINS)。[结果](1)NFDR胰岛素抵抗指数(IRI)(3.1+1.2)明显高于对照组(P<0.05)。(2)NFDR脂联素水平(7±2)mg/L、R1(43±14)个/红细胞、R2(2221±434)个/红细胞明显低于对照组(P<0.05,P<0.01),而瘦素水平明显高于对照组(P<0.05)。(3)NFDR的TG水平明显高于对照组(P<0.05)。(4)IRI为应变量的多元线性逐步回归分析结果示,BMI、瘦素均与IRI呈显著正相关,脂联素和R1、R2与IRI呈显著负相关(P<0.05或P<0.01)。[结论]NFDR血清脂联素水平和R1、R2较低,瘦素水平较高,存在明显胰岛素抵抗,脂联素、瘦素和胰岛素受体数目的改变参与了NFDR胰岛素抵抗的发生。

[Objiective] To investigate the relationship of serum adiponection, leptin and insulin receptor levels with insulin resistance （IR） in the nondiabetic first - degree relatives of type 2 diabetes mellitus （NFDR）. [Methods] Fasting plasma glucose （FBG）, fasting serum insulin （FINS）, adiponection, leptin, insulin receptor, lipid, 2h plasma glucose （2hBG） as well as 2h serum insulin （2hINS） were determined in 60 NFDR and 40 control subjects（C）. [Results] The insulin resistance index （IRI） （3.1±1.2） was significantly higher in NFDR than those C （P 〈 0.05）; adiponection（7±2）mg/L, R1（43±14）/red blood cell （P 〈 0.05） and R2 （2221±434）/red blood cell （P 〈 0.01） were significantly lower in NFDR than those C; Leptin was significantly higher in NFDR; Serum triglyceride level was significantly higher in NFDR than those C （P 〈 0.05）; In NFDR, Multiple linear stepwise regression analysis indicated that BMI and leptin were positively correlated with IRI, adiponection, R1, and R2 were negative correlated with IRI. [Conclusion] Adiponection, R1, and R2 are significantly lower and leptin is higher in NFDR compared with those C, There are the higher insulin resistance in NFDR than those C, adiponection, leptin, R1 and R2 may affect the IR of NFDR.