2型糖尿病患者血清抵抗素肿瘤坏死因子与胰岛素抵抗相关性研究

RELATIONSHIP RETWEEN INSULIN RESISTANCE AND THE LEVEL OF SERUM RESISTIN AND TUMOR NECROSIS FACTOR-α IN TYPE Ⅱ DIABETES MELLITUS PATIENTS

目的探讨2型糖尿病(T2DM)患者血清抵抗素(Resistin)、肿瘤坏死因子(TNF-α)水平变化与胰岛素抵抗之间的相关性。方法随机选择30例非肥胖2型糖尿病(NDM)患者、30例肥胖2型糖尿病(ODM)患者、30例健康对照者,测定其血清Resistin、TNF-α水平,同时测定其他有关指标,用Homa公式计算胰岛素抵抗指数(IRI),并进行相关分析。结果NDM组和ODM组空腹Re-sistin、TNF-α水平均明显高于对照组,差异有显著性(P<0.05,P<0.01);ODM组的Resistin、TNF-α水平与NDM组差异有显著意义(P<0.05)。ODM组Resistin与BMI、FPG、HbA1C、TG和IRI呈显著正相关,与FINS、TC、SBP、DBP无相关性。TNF-α水平与BMI、FPG、HbA1C、TG、FINS和IRI呈显著正相关,与SBP、DBP无相关。结论2型糖尿病患者特别是肥胖者胰岛素抵抗更为显著,Resistin和TNF-α均参与胰岛素抵抗,可能是影响体内胰岛素抵抗的重要相关因素。

Objective To explore the relationship between insulin resistance（IR） and the levels of serum resistin and tumor necrosis factor-alpha（TNF-α） in type Ⅱ diabetes Mellitus（DM） patients. Methods 30 cases of non-bese Type Ⅱ DM, 30 cases of obese Type Ⅱ DM and 30 healthy cases were randomly selected in this resparch. The levels of serum resistin, TNF-α and other related indexes were determined. The IR indexes（ IRI ） were calculated through homeostasis model assessments（Homa）. And then corrlational analyses were made. Results There existed significant difference between the non-obese and obese groups and the contrast group in terms of the levels of fasting serum resistin and TNF-α because much higher levels were found in the two group than in the contast group（ P 〈 0.05, P 〈 0.01 ）, There also existed significant difference between the non-obese group and the obese group（ P 〈 0.05）. In the obese group, the level of serum resistin positively correlated with BMI, FPG, HbA1 C, TG, FINS, and IRI, but showed no correlation with FINS, TCH, SBP and DBP. The level of TNF-α positively correlated with BMI, FPG, HbA1 C, TG, FINS and IRI, but not with SBP and DBP. Conclusion In TYPE Ⅱ DM Patients, especially obese one, both serum resistin and TNF-α may result in IR, which might be the major factors in causing IR.