初发2型糖尿病患者血清RegⅠα水平及其临床意义初探

The serum level of Reg Ⅰα and potential clinical implication in new-onset type 2 diabetic patients

目的观察初发2型糖尿病患者的血清RegⅠα水平,并分析其与其他临床指标的相关性,探讨其可能的临床意义。方法经口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)入选110名正常糖耐量(normal glucose tolerance,NGT)和46名2型糖尿病患者(type 2 diabetes mellitus,T2DM)。酶联免疫吸附测定测定血清RegⅠα和胰岛素、C反应蛋白(hs-CRP)、人脂肪细胞脂肪酸结合蛋白(A-FABP)、脂联素等。结果NGT组和T2DM组的血清RegⅠα水平无显著差异[(626.82±359.60)ng/mLvs(610.11±326.01)ng/mL,P=0.788];在所有研究对象中,血清RegⅠα水平与年龄正相关,同时与腰臀比(WHR)、A-FABP、hs-CRP呈正相关,与高密度脂蛋白(HDL-C)呈负相关,与空腹血糖(FPG)和OGTT 2 h血糖和胰岛素水平无明显相关性。校正年龄因素后,RegⅠα水平与A-FABP正相关,与HDL-C负相关。但在T2DM组,RegⅠα和A-FABP、HOMA-B成正相关(r值分别为0.428,0.424;P值分别为0.042,0.044),和FPG、糖化血红蛋白1(HbA1c)呈负相关(r分别为-0.525,-0.425,P值分别为0.01,0.043)。结论与NGT相比,初发T2DM患者血清RegⅠα水平没有明显差异;在T2DM患者血清RegⅠα与胰岛功能和血糖水平有一定的关系,提示RegⅠα有可能参与T2DM的β细胞代偿,有可能是评价胰岛功能的指标之一。

Objective To investigate Reg Iα level in the serum of new developed type 2 diabetic patients （T2DM） compared with people with normal glucose tolerance （NGT） and to explore its potential clinical implication. Methods After oral glucose tolerance test （OGTT）, 46 patients with T2DM and 110 with NGT were enrolled. Clinical data such as body mass index （BMI）, the serum level of Reg I α, human adipocyte fatty acid binding protein （A-FABP）, human supersensitive C reactive protein （hs-CRP） and adiponectin were measured. Results No significant difference in serumReg Iαlevelwas detected between NGT andT2DM [（626.82±359.60）ng/mLvs （610.11± 326.01）ng/mL, P = 0. 788]. In whole subjects, serum Reg I α level was positively correlated with age, waist-to-hip ratio （WHR） and A-FABP, hs-CRP in the serum, while negatively correlated with high density lipoprotein-cholesterol （HDL-C）. After adjustment for age, A-FABP and HOMA-B remained significantly correlated with Reg I α level. No significant correlation was found between Reg Iα and glucose level, HOMA-IR, HOMA-B in all subjects, but serum Reg I α was negatively correlated with FPG and HbAlc while positively correlated with HOMA B in T2DM patients.Conclusions Serum Reg I α is suggested to be a marker associated with islet function of patients with T2DM and Reg I α is possibly involved in the mechanisms of β cell compensation.