维持性血液透析患者血清脂联素水平与胰岛素抵抗的关系初探

The relationship between serum adiponectin and insulin resistance in maintenance hemodialysis patients

目的探讨维持血液透析(MHD)患者血清脂联素(ADPN)水平与胰岛素抵抗的关系。方法选择首都医科大学附属北京朝阳医院肾内科60例MHD患者和30例正常对照者,分别测定血清ADPN水平、空腹胰岛素(FINS)及空腹血糖(FBG),并根据公式计算胰岛素敏感指数(ISI)和稳态模型胰岛素抵抗指数(Homa-IR)。结果MHD组的FINS、FBG、Homa-IR明显高于对照组(P<0.01),ISI明显低于对照组(P<0.01)。MHD组和对照组血清ADPN水平分别为(23.75±8.97)mg/L和(9.13±3.39)mg/L,两者间差异具有显著性(P<0.05)。相关分析表明,血清ADPN与FINS、ISI呈明显正相关(r分别为0.453、0.534,P均<0.01),而与Homa-IR呈明显负相关(r为-0.471,P<0.01)。结论维持性血液透析患者血清ADPN水平升高,血清ADPN水平与维持性血液透析患者胰岛素抵抗密切相关。

Objective To determine the relationship between serum adiponectin and insulin resistance in maintenance hemodialysis patients. Methods Sixty maintenance hemodialysis patients and 30 healthy volunteers were included in this study. Serum adiponectin （ADPN）, fasting insulin and fasting glucose were measured. Insulin sensitivity index （ISI） and homeostasis model insulin resistance index （Homa-IR） were calculated by established formulas. Results Serum ADPN was higher in patients （23.75 ± 8.97 mg/L） than in controls （9.13±3.39 mg/L） （P 〈 0.05）. Serum fasting insulin, fasting glucose and Homa-IR were also higher in patients than in controls. ISI was lower in patients than in controls. Serum fasting insulin and ISI were positively correlated with ADPN （r = 0.453 and 0.534, respectively, P 〈 0.01）. Homa-IR was negative correlated with ADPN （r=-0.471, P 〈 0.01）. Conclusion Serum adiponectin is higher in maintenance hemodialysis patients. Serum adiponectin level is closely correlated with insulin resistance in maintenance hemodialysis patients.