2型糖尿病伴高甘油三酯血症患者血清胰岛素样生长因子结合蛋白1水平与胰岛素抵抗的相关性分析

Relationship of serum level of IGFBP-1 with insulin resistance in type 2 diabetics with hypertriglyceridemia

目的探讨糖、脂代谢不同人群的血清胰岛素样生长因子结合蛋白1(IGFBP-1)水平与胰岛素抵抗(IR)的关系。方法选取正常人(NC)、高TG血症患者、2型糖尿病(T2DM)患者及T2DM+高TG患者共66例,测定血清IGFBP-1、胰岛素、血糖和血脂水平。结果(1)血清IGFBP-1水平,高TG血症组较NC组、T2DM+高TG组较T2DM组均明显下降(P<0.05)。(2)多元逐步回归分析显示血清IGFBP-1水平与TG、HOMA-IR负相关(P<0.05),与HDL-C正相关(P<0.05)。结论高TG血症人群血清IGFBP-1明显下降,提示存在明显肝脏IR。

Objective To observe serum levels of insulin-like growth factor binding protein-1 （IGFBP-1） in normal subjects and subjects with type 2 diabetes mellitus （T2DM） and hypertriglyceridemia, and to evaluate their possible relationships with insulin resistance. Methods IGFBP-1 was measured by enzyme-linked immunosorbent assays in 15 subjects with T2DM without hypertriglyceridemia, 21 subjects with both T2DM and hypertriglyceridemia, 15 subjects only with hypertriglyceridemia, and 15 normal subjects. Fasting plasma levels of glucose, lipids, insulin and HOMA-IR were measured in all subjects. Results （1） Compared with the control （3.36±0.29 ng/ml）, serum level of IGFBP-1 significantly decreased in subjects with hypertriglyceridemia （2.37± 0.46 ng/ml） （P〈 0.05）. The subjects with both T2DM and hypertriglyeeridemia had lower level of IGFBP-1 （3.01 ± 0. 47 ng/ml） than subjects with T2DM without hypertriglyceridemia （3. 45 ± 0.37 ng/ml） （P〈 0.05）. （2） Serum IGFBP-1 level was negatively correlated with triglyceride （β′=-0. 506, P= 0. 008） and HOMA-IR （β′=0. 106,P=0. 033） （P〈0. 05）, and positively correlated with high density lipoprotein （β′=0. 667,P=0. 004） （P〈0.05）. Conclusions Serum IGFBP-1 level significantly decreases in subjects with hypertriglyceridemia. Plasma triglyceride has significant effect on hepatic insulin resistance.