血清脂肪细胞脂肪酸结合蛋白与社区人群2型糖尿病的相关性研究

Relations between serum adipocyte fatty acid-binding protein and type 2 diabetes in a community population

目的研究血清脂肪细胞脂肪酸结合蛋白（A-FABP）水平与社区人群2型糖尿病的相关性。方法在广州市海珠区整群分层随机抽样法抽取255名45~85岁社区居民,平均年龄63.90岁,测定空腹血糖（FPG）、餐后2小时血糖（2hPG）、糖化血红蛋白（HbA1c）、体重指数（BMI）、腰围（WC）、臀围（HC）、腰臀比（WHR）、血压（BP）、甘油三脂（TG）、胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）,计算胰岛素抵抗指数（HOMA-IR）,酶联免疫吸附法（ELISA）测定血清A-FABP及空腹胰岛素（FINs）水平,根据血糖情况分为3组：血糖正常组（A组）：90例,糖耐量受损组（B组）：85例,糖尿病组（C组）：80例,比较各组A-FABP的水平。结果与A组相比,B组、C组FPG、2hPGh、HbA1C、HOMA-IR、SBP、WC、WHR均明显升高（P=0.00）,FINs、DBP、TG、HDL-C也显著增高（P=0.038、0.047、0.01、0.046）;与B组相比,C组FPG、2hPG、HbA1c、TG、SBP均明显升高（P=0.00）,FINs、BMI、WC、DBP、HDL-C也显著增高（P=0.012、0.006、0.03、0.019、0.029）。A-FABP在A组、B组和C组的浓度差异有统计学意义（P=0.00）,呈升高趋势。而以上3组年龄差异对A-FABP的影响无统计学意义（P〉0.05）。A-FABP浓度与FPB、2hPG、FINS、WHR、BMI、WC、SBP、HOMA-IR呈直线正相关,与TG、HDL-C呈负相关（P=0.00）。结论血清A-FABP表达升高与糖调节异常相关,是社区人群2型糖尿病发生、发展的重要标志物。

Objective To study the relationship between the serum levels of adipocyte fatty acid-binding protein（A-FABP） level and type 2 diabetes mellitus in a community population.Methods A total of 255 residents（aged 45-85 years） were randomly selected from 4 communities in Guangzhou to examine the fasting plasma glucose（FPG）,2-hour postprandial blood glucose（2hPG）,glycosylated hemoglobin（HbA1c）,body mass index（BMI）,waist circumference（WC）,hip circumference（HC）,waist-to-hip ratio（WHR）,blood pressure（BP）,triglyceride（TG）,cholesterol（TC）,high-density lipoprotein cholesterol（HDL-C）,and low-density lipoprotein cholesterol（LDL-C）.The insulin resistance index（HOMA-IR） was calculated and enzyme-linked immunosorbent assay（ELISA） was used to determine serum A-FABP and fasting insulin（FINs） levels.The cases were divided into 3 groups according to blood glucose level,namely the normal group（group A,n=90）,impaired glucose tolerance group（group B,n=85）,and diabetic group（group C,n=80）,and the A-FABP levels were compared between them.Results Compared with group A,the subjects in groups B and C showed significantly increased FPG,2hPGh,HbA1C,HOMA-IR,systolic blood pressure（SBP）,and waist circumference（P=0.000） as well as FINs,WHR,diastolic blood pressure（DBP）,TG,and HDL-C（P=0.038,0.047,0.01,and 0.046,respectively）.Compared with group B,group C showed significantly higher FPG,2hPG,HbA1c,TG,and SBP（P=0.00）,with also higher levels of FINs,BMI,WC,DBP,and HDL-C（P=0.012,0.006,0.03,0.019,and 0.029,respectively）.A-FABP increased significantly in the order of group A,B,and C（P=0.00）,and this result was not affected by the differences in age between the 3 groups（P0.05）.A-FABP level was positively correlated to FPB,2hPG,FINS,WHR,BMI,WC,SBP,and HOMA-IR,but inversely to TG and HDL-C（P=0.00）.Conclusion Elevated serum A-FABP is closely related to glucose metabolism disorder,and A-FABP may serve as a useful marker for the occurrence and development of type 2 diabetes in the community population.