新诊断2型糖尿病患者血清内脂素与视黄醇结合蛋白4水平变化及其与胰岛素抵抗的关系

Relationship of Serum Visfatin to Retinol-binding Protein 4 level and to Insulin Resistance in Newly-diagnosed T2DM Patients

目的探讨新诊断2型糖尿病(T2DM)患者血清内脂素(Visfatin)与视黄醇结合蛋白4(RBP4)表达水平及其与胰岛素抵抗(IR)的关系。方法选取新诊断T2DM患者78例(T2DM组)及健康体检者30例(NC组)。检测两组空腹血清Visfatin和RBP4水平,并计算其胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HO-MA-β)、胰岛素敏感性(ISI),对Visfatin、RBP4及其他因素进行单因素相关分析,然后进行多元逐步回归分析。结果 (1)T2DM组患者血清Visfatin〔(31.0±12.5)ng/ml〕和RBP4〔(15.3±2.9)ng/ml〕水平显著高于NC组〔(13.3±7.6)ng/ml,(11.4±1.7)ng/ml〕,差异有统计学意义(P<0.01)。(2)单因素相关分析显示,血清Visfa-tin和RBP4均与体质指数、三酰甘油(TG)、总胆固醇(TC)、空腹血糖(FPG)、HOMA-IR呈正相关(P<0.05);与HOMA-β、ISI呈负相关(P<0.01);Visfatin与RBP4呈正相关(P<0.01)。(3)多元逐步回归分析发现,Visfa-tin、TG和FPG为影响RBP4的最显著因素,常数项为零;RBP4为影响Visfatin最显著因素,常数项为0.335。结论 T2DM患者血清Visfatin、RBP4均显著升高,且二者呈正相关;Visfatin水平高表达除类胰岛素样作用外还可能与胰岛β细胞功能有关,RBP4水平升高可能参与了IR及T2DM的发生、发展。

Objective To explore the relationship of serum visfatin to retinol-binding protein 4（RBP4） expression and to insulin resistance（IR） in newly-diagnosed type 2 diabetes mellitus（T2DM） patients.Methods Seventy-eight newly-diagnosed T2DM patients were divided into groups T2DM,control（healthy subjects）.The fasting serum visfatin and RBP4 levels were determined;insulin resistance index（HOMA-IR）,pancreatic β cell function index（HOMA-β）,insulin sensitivity index（ISI） were calculated;univariate analysis was performed on visfatin,RBP4 and other factors,and then multiple regression analysis.Results The levels of serum visfatin and RBP4 were significantly higher in T2DM group（31.0±12.5 ng/ml,15.3±2.9 ng/ml,respectively） than in control（13.3±7.6 ng/ml,11.4±1.7 ng/ml,respectively）（P0.01）.Univariate analysis showed that both visfatin and RBP4 were positively correlated with body mass index,triglyceride（TG）,total cholesterol（TC）,fasting plasma glucose（FPG） and HOMA-IR（P0.05）,negatively with HOMA-β and ISI（P0.01）,and Visfatin positively with RBP4（P0.01）.Multiple regression analysis showed that visfatin,TG and FPG were the most significant factors influencing RBP4,the constant term was zero,RBP4 was the most significant factor influencing visfatin,the constant term was 0.335.Conclusion Serum visfatin and RBP4 levels,which are positively correlated,significantly increase in T2DM patients.High expression of visfatin may be related to β-cell function besides insulin-like actions.The increase of RBP4 level may be involved in the occurrence and development of IR and T2DM.