不同人群血清抵抗素表达及影响因素的临床研究

Resistin serum levels in different groups and related factors

目的通过观察不同人群中血糖、血压、血脂和胰岛素抵抗指数等指标与血清抵抗素的关系,探讨抵抗素与肥胖和2型糖尿病的关系。方法随机选择55例2型糖尿病患者和34例健康人,根据血糖水平和体重指数(BMI)分为正常体重组(A组)、单纯肥胖组(B组)、非肥胖糖尿病组(C组)和肥胖合并糖尿病组(D组)。检测血清抵抗素水平、糖化血红蛋白(HbA1c)及空腹胰岛素(FINS)、空腹血糖(FPG)、血清总胆固醇(TC)、甘油三脂(TG)及低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平,根据HOMA模型计算胰岛素抵抗指数。通过分析各组抵抗素水平的不同及与临床各指标的相关性,分析其影响因素。结果D组的血清抵抗素显著高于A、B和C组(P值均<0.001)。B组和C组的血清抵抗素显著高于A组(P<0.05,P<0.01)。直线相关分析显示,血清抵抗素浓度与HbA1c、LDL、IRI、SBP和BMI成正相关(r=0.222-r=0.233,r=0.286,r=0.407,r=0.480),与HDL和FINS成负相关(r=-0.198,r=-0.138)。多元逐步回归分析显示,血清抵抗素浓度受BMI、HbA1c和收缩压影响较大。结论抵抗素是联系肥胖与2型糖尿病的信号分子,参与胰岛素抵抗和肥胖的发生。抵抗素不仅参与影响血糖和血脂的代谢,而且与高血压也有相关性。

Objective To investigate the role of resistin in obesity and type 2 diabetes mellitus. Methods 55 patients with type 2 diabetes mellitus and 34 healthy controls were randomly enrolled in this study. No dysfunctions of heart, hver or kidney or other endocrine diseases were found. Based on plasma glucose and BMI, they were divided into four groups： the normal control group, the obese control group, the non-obese T2DM group, and the obese T2DM group. The levels of serum resistin, HbAlc, blood-fat, fasting plama glucose, and fasting insulin were determined. The insulin resistance index was calculated based on the HOMA model（HOMA-IRI = FINS × FPG/22.5）. Results The serum level of resistin of the obese T2DM group [（14.02 ± 4.68）ng/mL] was significantly higher than that of the other three groups （P 〈0.001）. The serum resistin levels of the obese group[（8.14 ± 2.84） ng,/mL] and the non-obese T2DM group [（8.56± 5.02）ng/mL] were significantly higher than that of the normal control group[（5.62 ± 1.56）ng,/mL] （P 〈 0.05, P 〈 0.01）. There were positive correlations between the level of serum resistin and the levels of HbAlc, LDL, IRI, SBP and BMI（ r = 0.222, r = 0.233, r = 0.286, r = 0.407, r = 0.480, respectively）, and negative correlations between serum resistin and HDL and FINS （ r = - 0.198, r = - 0.138, respectively）. Stepwise regression analysis showed that BMI, HbA1 c and systolic blood pressure highly influenced the serum level of resistin. Conclusion Resistin is an important factor linking obesity and type 2 diabetes mellitus. It may play a role in insulin resistance and obesity. Resistin is not only related to the metabolism of blood glucose and lipids, but also related to hypertension.