代谢综合征患者葡萄糖代谢率与血浆抵抗素关系的研究

Relationship of Glucose Metabolic Rate and Plasma Resistin Levels in Subjects with Metabolic Syndrome

目的探讨代谢综合征(MS)人群葡萄糖代谢率(M)与血浆抵抗素(resistin)水平变化的关系。方法筛选30例MS病例和20例健康对照组。所有受试者均进行高胰岛素-正常血糖钳夹试验;检测血浆resistin水平及空腹胰岛素、血糖、血脂等生化等生化指标;测定血压、腰围(WC)、身高、体重等人体参数。结果 (1)高胰岛素-正常血糖钳夹试验稳态时(120-150 min)对照组和MS组的M分别为8.33±1.59 mg.kg-1.min-1和4.13±1.34 mg.kg-1.min-1,MS组的M显著低于对照组,差异有统计学意义(P<0.01)。2.对照组与MS组的血浆resistin水平分别为11.35±4.04 ng/mL与10.91±4.02 ng/mL,与对照组比较,MS组的血浆resistin水平无显著性差异(P>0.05)。3.在MS组,resistin与体重指数(BMI)、WC、空腹血糖(FPG)、2小时血糖(2 hPG)、空腹胰岛素(FINS)、甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-C)、M等指标的相关系数r值分别为:0.156、0.115、0.138、-0.057、0.103、0.175、-0.149及-0.135,P均>0.05,resistin与上述指标无相关关系。结论 (1)本研究成功应用高胰岛素-正常血糖钳夹技术评估了30例MS患者和20例正常对照人群的M,结果显示本组MS患者的M显著低于对照组,提示本组MS患者胰岛素敏感性降低,存在明显的胰岛素抵抗IR。(2)本研究未观察到本组MS患者血浆resistin水平的明显变化,也未发现其胰岛素敏感性的变化与resistin有相关性,提示临床MS患者resistin与IR关系的复杂性及可能存在异质性,有待今后进一步研究。

Objective To investigate the changes of glucose metabolic rate and plasma resistin levels in subjects with metabolic syndrome（MS）.Methods 30 subjects with MS were selected as MS group.20 normal adults were selected as control group.Glucose metabolic rate was evaluated by way of hyperinsulinemic euglycemia clamp technique and plasma resistin concentrations were detected by enzyme linked immunosorbent assay（ELISA）.Blood pressure,waist circumference（WC）,body weight and body height were measured.Results（1）During the steady state（last 30 mins） in the hyperinsulinemic euglycemia clamp,M in MS group was significantly lower than that in controls.（4.13±1.34 mg·kg-1·min-1 vs 8.33±1.59 mg·kg-1·min-1,respectively,P0.01）.（2）Plasma resistin levels in MS group was no significantly difference from that in controls（10.91±4.02 vs 11.35±4.04 ng/mL,respectively,P0.05 for all correlations）.（3）No significant association of resistin with BMI,WC,FPG,2 hPG,FINS,TG,HDL-C and M was found.（r=0.156,0.115,0.138,-0.057,0.103,0.175,-0.149,-0.135,respectively,P0.05 for all correlations）.Conclusion （1）In this study,we successfully evaluated insulin sensitivity of 50 subjects（30 in MS group and 20 in controls） by means of hyperinsulinemic euglycemic clamp technique.Our finding showed insulin sensitivity of subjects with MS in this study was significantly decreased.（2）Plasma resistin levels were not significantly different between MS and control group,suggesting that plasma resistin levels were not be associated with IR in subjects with MS.