初诊DM2患者脂联素、炎性因子与胰岛素抵抗的相关分析

Study on the Relationship Between Changes of Serum,Adiponectin Some Inflammatory Cytokines Levels and Insulin Resistance in Newly Diagnosed Type 2 Diabetes Mellitus Patients

目的:分析初诊2型糖尿病(DM2)患者脂联素、IL-6、TNF-α水平变化及其与胰岛素抵抗(IR)、肥胖的相关性。方法:选择初诊DM292例,分为肥胖组(体重指数BMI≥25kg/m2)42例、非肥胖组(BMI<25kg/m2)50例、正常对照组40例,测定血清脂联素、IL-6、TNF-α、体重、身高、血脂、空腹血糖(fPG)、餐后2h血糖(2hPG)、空腹胰岛素(fINS)、餐后2h胰岛素(2hINS)、计算胰岛素抵抗指数(HOMA-IR),做相关性分析。结果:肥胖组脂联素低于非肥胖组(P<0.05)及正常对照组(P<0.01),非肥胖组又低于正常对照组(P<0.05)。而肥胖组IL-6、TNF-α高于非肥胖组(P<0.05)及正常对照组(P<0.01),非肥胖组又高于正常对照组(P<0.05)。脂联素与BMI、HOMA-IR呈负相关,IL-6、TNF-α与BMI、HOMA-IR呈正相关。结论:脂联素、IL-6、TNF-α与IR密切相关,参与了糖脂代谢紊乱。

Abstract Objective To study the relationship between changes of serum adiponectin, interleukin- 6 （ IL - 6） tumor necrosis factor-α （TNF- α） levels and insulin resistance （IR） , obesity parameters in newly diagnosed type 2 diabetes meUitus （DIVL2） patients. Methods Serum adiponectin （with RIA）, IL- 6, TNF -α （with ELISA） levels as well as fBG, 2hPG, fasting insulin, 2h insulin, lipid profile were measured in 42 obese newly diagnosed DM2 patients （ BMI 〉 25 ）, 50 non - obese DM2 patients （ BMI 〈 25） and 40 controls. Results The levels of adiponectin obese group were significantly those in the other groups （ P 〈 0.05 ＆ P 〈 0.01 ）, while levels in non - obese group were significantly lower than those in controls （ P 〈 0.01 ）. The levels of IL - 6 and TNF - α in obese group were significantly higher than those in the other groups （ P 〈 0.05 ＆ P 〈 0.01 ）, while the levels in non - obese group were significantly higher than the levels in controls （ P 〈 0.01 ）. The adiponectin levels were negatively correlated with insulin resistance （ HO- MA -IR） and BMI, while the cytokines levels were posisitively correlated with HOMA -IR and BMI. Conclusion Adiponectin, IL - 6 and TNF - α are closely related with insulin resistance, and take parts in development of the abnormal glucose metabolism.