2型糖尿病患者血清脂联素与炎症因子的相关性研究

STUDY OF CORRELATION BETWEEN SERUM ADIPONECTIN LEVEL AND INFLAMMATORY FACTORS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

目的探讨2型糖尿病患者血清脂联素与炎症因子的相关性,并观察抗炎药物对糖尿病患者的疗效。方法将我院门诊及住院2型糖尿病(T2DM)患者分为T2DM无大血管并发症患者(无病变组)55例及T2DM合并大血管病变患者(病变组)45例,以健康人30例为对照组。分别检测各组FPG、胰岛素、糖化血红蛋白、血脂、游离脂肪酸、血清CRP、脂联素、瘦素及肿瘤坏死因子TNF-α;并计算体质指数、腰臀比、胰岛素敏感性指数及胰岛素抵抗指数。T2DM患者均予抗炎治疗,并观察1年后检测以上指标。结果①T2DM患者血清脂联素、炎症因子及其他相关指标均与健康人有统计学差异,而且病变组较无病变组,WHR、FPG、HbA1C、FFA、CRP、Leptin及TNF-α显著升高及APN显著降低。②APN水平与BMI、FFA、WHR、FBG、HbA1C、HOMA-IR、CRP及TNF-α呈显著负相关。多元逐步回归分析显示APN与CRP、TNF-α、WHR及HbA1C呈显著相关。③予抗炎治疗1年后,患者FPG、FINS、HOMA-IR、TNF-α、CRP、FFA明显降低,ISI、APN增加。结论APN是T2DM和动脉粥样硬化的保护性因子,其作用的发挥是通过拮抗炎症因子实现的。干预炎症过程的长期药物治疗,将成为改善IR、治疗T2DM的新趋向。

Objective To investigate the correlation between serum adiponectin level and inflammatory factors in patients with type 2 diabetes mellitus （T2DM）. Methods All the patients with T2DM participating in the study were divided into two groups： NMC group, 55 patients with T2DM having no macrovascular complications; MC group, 45 patients with T2DM having macrovascular complications. To set 30 healthy subjects as the control group. The levels of fasting serum adiponectin （ APN）, C - reactive protein（ CRP）, tumor necrosis factor -α（ TNF - α）, fasting and postprandial 2 hour blood glucose, serum lipids , FINS and HbA1C were measured, and the anthropometrical parameters such as body mass index （BMI）, waist hip ratio （WHR） insulin sensitive index （ISI）, HOMA - IR were evaluated. Results ①The levels of APN and others inflammatory factors in the patients with type 2 diabetes mellitus were significantly different to healthy people. In addition, the levels of WHR, FPG, HbA1C, FFA, CRP, Leptin and TNF -α in MC group were all significantly higher than the NMC group, while the levels of ANP in MC group was much lower.②Serum adiponectin was correlated negatively with BMI, FFA,WHR,FBG, HOMA- IR, HbA1C, CRP and TNF- α. ③After healing of T2DM patients using anti -inflammatory treatment in one year, the levels of FPG, FINS, HOMA -IR, TNF -α, CRP, FFA were greatly decreased and ISI and APN were been rising. Conclusion Adiponecfin might be a protective factor in the inflammatory reaction during the occurrence and development of T2DM and atherosclerosis in the patients. To interfere in the inflammatory reaction with anti - inflammatory treatment might be the new tendency for improving insulin resistance and curing T2DM.