急性冠脉综合征合并2型糖尿病患者脂联素水平观察

Observation of Serum Concentration of Adiponectin in Patients With Acute Coronary Syndrome With Type 2 Diabetes Mellitus

目的:探讨急性冠脉综合征(ACS)合并2型糖尿病(T2DM)或糖耐量异常(IGT)时血清脂联素(APN)水平及与血脂、胰岛素抵抗的关系。方法:将40例ACS患者分为3组,单纯ACS组,ACS合并T2DM组,AGT组,并以16例正常者作为对照测定空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、体重指数(BMI)、血清脂联素(APN)、胰岛素(FINS)、胰岛素抵抗(IR)。结果:ACS合并T2DM组、合并IGT组、单纯ACS组的APN水平均明显低于NC组(P均<0.01),且合并T2DM组的APN水平也明显低于单纯ACS组(P<0.01),合并T2DM组与合并IGT组间APN水平没有明显差异,合并IGT组与单纯ACS组间亦无明显差异;校正FBG、FINS和IR后,APN与LDL-C负相关(r=-0.322,P<0.05),与HDL-C正相关(r=0.330,P<0.05),校正TG、HDL-C、LDL-C后,APN与FBG、FINS、IR负相关(r分别为-0.270,-0.238,-0.257,P均<0.05)。结论:APN与调节血脂、抗动脉粥样硬化、改善胰岛素抵抗有关。

Objective：To investigate the serum concentration of adiponectin （APN） in patients with acute coronary syndrome（ACS） with type 2 diabetes mellitus （T2DM） or impaired glucose tolerance （IGT） and the relationship between APN and lipid, insulin resistence（IR）. Methods： Fourty patients with ACS were divided into 3 groups： ACS group, ACS with T2DM group, ACS with IGT group, and the other 16 cases as normal control （NC）. Fasting blood glucose （FBG）, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol（LDL-C）, body mass index（BMI）, APN, fasting insulin（FINS）, insulin resistance （IR） were measured. Results： APN concentration in ACS groups with T2DM, IGT and ACS group was markedly lower than that in NC group（P〈0. 01）. ACS with T2DM group had even lower APN level than that in ACS group （P〈0. 01）. There-was no significant difference in APN concentration between ACS with T2DM group and ACS with IGT group,so was ACS with IGT group and ACS group. APN level was negatively correlated with LDL-C（r= - 0. 322,P〈0. 05）, and positively correlated with HDL-C（r = 0. 330, P〈0. 05）. APN negatively correlated with FBG, FINS and IR （r were - 0. 270, - 0. 238, - 0. 257 respectively, P〈0. 05）. Conclusion：APN correlated with lipids regulation, anti-atherosclerosis and improvement of IR.