肥胖者外周血Obestatin、Ghrelin水平变化与胰岛素抵抗的关系

Relation between the levels of circulating Obestatin,Ghrelin and insulin resistance in obesities

目的探讨肥胖患者外周血Obestatin、Ghrelin水平变化与胰岛素抵抗(IR)的关系。方法选取正常对照组24例,单纯肥胖组30例,肥胖-糖代谢异常组(包括初诊断2型糖尿病或糖耐量受损患者)36例。测定空腹Obestatin、Ghrelin水平和空腹胰岛素(FPI),并计算稳态模型评价HOMA-IR。比较不同IR程度下Obestatin、Ghrelin水平的变化。结果单纯肥胖组、肥胖-糖代谢异常组患者空腹外周血Obestatin、Ghrelin水平均明显低于正常对照组(P<0.05,P<0.01),HOMA-IR、FPI、三酰甘油(TG)均高于正常组。与单纯肥胖组相比,肥胖-糖代谢异常组血中Obestatin、Gh-relin水平明显降低(P<0.01,P<0.05),HOMA-IR、空腹血糖(FPG)、FPI、TG明显增高(P<0.05)。线性相关分析表明Obestatin、Ghrelin均分别与BM I、HOMA-IR负相关(P<0.05),Obestatin与Ghrelin正相关。多元逐步回归分析显示BM I、HOMA-IR是影响Obestatin、Ghrelin水平的独立相关因素。结论 Obestatin、Ghrelin水平的降低可能参与了肥胖、IR的发生,并可能具有防止肥胖和2型糖尿病继续发展的作用。

Objective To investigate the levels of circulating Obestatin and Ghrelin in obesities and the relationship with insulin resistance（IR）.Methods 24 normal controls,30 simple obesities,36 obesities with glycometabolism abnormalities（including type 2 diabetes or impaired glucose tolerance patients） were selected.Body height,body weight,blood pressure were measured,fasting plasma glucose（FPG）,circulating triglyceride（TG）,total cholesterol（TC）,Obestatin,Ghrelin and fasting plasma insulin（FPI） were measured 10 hours after meal and homeostasis model assessment-insulin resistance（HOMA-IR） was calculated.Results The levels of Obestatin and Ghrelin in simple obesity group,obese with glycometabolism abnormal group were decreased significantly than those of the normal control group（P0.05,P0.01）;HOMA-IR,FPI,TG levels were increased significantly than those in normal control group.Compared with the simple obesity group,the levels of plasma Obestatin and Ghrelin in the obesities with glycometabolism abnormal group were decreased significantly and the HOMA-IR,FPG,FPI,TG levels were increased significantly（P0.05,P0.01）.There were significant negative correlations respectively between the levels of Obestatin,Ghrelin and BMI,HOMA-IR.There was significant positive correlation between the levels of Obestatin and Ghrelin.Multiple linear regression analysis indicated that BMI,HOMAIR were the independent factors of affecting Obestatin and Ghrelin levels.Conclusions The decrease of circulating Obestatin and Ghrelin may be involved in the development of IR in subjects with obesity or abnormal glucose metabolism.