血清胰淀素水平与2型糖尿病胰岛素抵抗的关系

Relationship Between the Serum Amylin Level and Insulin Resistance in Patients with DM2

目的:探讨2型糖尿病(DM2)血清胰淀素水平的变化,研究胰淀素与胰岛素抵抗(IR)的关系。方法:收集初诊DM2患者46例,另选健康对照组41例,检测所有受试者空腹状态下胰淀素和血脂、血尿酸、空腹血糖及胰岛素水平,同时测定体重指数(BMI)和腰臀比(WHR),比较各组间差异。结果:与正常组相比,DM2组的胰淀素水平亦较对照组低(P<0.05),胰岛素抵抗指数(Homa-IR)显著高于对照组(P<0.05)。胰淀素与体重指数、腰臀比、空腹血糖、空腹胰岛素水平、Homa-IR、低密度脂蛋白胆固醇、三酰甘油呈显著负相关,与高密度脂蛋白胆固醇呈显著正相关。与胰岛β细胞功能、血清胆固醇、血尿酸无相关性。逐步多元回归分析提示腰臀比和空腹胰岛素水平是影响胰淀素水平最显著的因素。结论:DM2患者存在IR、低胰淀素血症,低胰淀素血症可能与DM2的IR互为因果。

Objective To explore the changes of the serum amylin levels in patients with type 2 diabetes （DM2） and to study the relationship between sertma amylin levels and insulin resistance （IR）. Methods Serum amylin （with ELISA）, blood lipid, serum uric acid, blood glucose （with biochemistry） and insulin （with CLIA） levels were measured in 41 mewly diagnosed DM2 patients and 41 controls. Meanwhile, body mass index （BMI） and waist/hip ratio （WHR） were ealctflated. Results The serum amylin levels in type 2 diabetic patients were significantly lower than those in the controls （ P 〈 0.05 ）. Amylin levels were significantly negatively correlated with BMI, WHR, fasting blood glucose, fasting insulin levels, Homa -IR, low-density lipoprotein cholesterol and triglyceride, but significantly positively correlated with high - density lipoprotein cholesterol with no correlation with β-cell function, serum cholesterol and uric acid levels. Stepwise regression analysis showed that WHR and fasting insulin level were the most strong factors in influencing the serum amylin leveb. Conclusion There were IR and hypoamylinemia in type 2 diabetic patients, hypoamylinemia and IR might be mutually aftected in DM2 patients.