老年2型糖尿病患者血清抵抗素水平与胰岛素抵抗的相关性研究

The relationship between the level of serum resistin and insulin resistance in the elderly patients with type 2 diabetes mellitus

目的探讨抵抗素在老年2型糖尿病患者中的作用及其与肥胖、胰岛素抵抗和高敏CRP、游离脂肪酸(FFA)、血糖、血压、血脂等危险因素的关系。方法选取2009年6月—2010年2月于内分泌科病房治疗的老年2型糖尿病患者82例,根据体质量指数分为糖尿病非肥胖组40例及糖尿病肥胖组42例。选取同期老年健康体检者30例为健康对照组。检测空腹血清抵抗素及相关代谢指标,并进行相关性分析。结果糖尿病肥胖组和非肥胖组抵抗素水平均高于健康对照组,差异有统计学意义(P<0.05,P<0.01);糖尿病肥胖组高于糖尿病非肥胖组,差异有统计学意义(P<0.01)。糖尿病肥胖组游离脂肪酸水平显著高于糖尿病非肥胖组及健康对照组,差异有统计学意义(P均<0.01);多元逐步回归分析显示,抵抗素受HOMA-IR、腰臀比影响较大。结论空腹血清抵抗素水平在老年2型糖尿病患者尤其是伴有肥胖的患者中显著升高,与HOMA-IR、腰臀比呈明显的正相关性,抵抗素可能在胰岛素抵抗、肥胖和糖尿病之间发挥重要作用。

Objective The purpose of this study was to investigate the potential roles of the resistin in the elderly patients with type 2 diabetes,and to evaluate the correlations among resistin and markers of obesity,insulin resistance,high sensitivity C reactive protein（hs-CRP）,free fat acid（FFA） and metabolic parameters.Methods Eighty-two cases of elderly patients suffering from type 2 diabetes mellitus were randomly selected from June 2009 to February 2010.According to BMI which were divided into non obese type 2 DM group（40 cases） and obese type 2 DM group（42 cases）.Another 30 healthy elderly people were enrolled as normal control group.The serum resistin and metabolic parameters were detected,and correlation study was performed.Results The concentrations of resistin in non-obese type 2 DM and obese type 2 DM groups were statistically higher than that of the normal control group（P0.05,P0.01 respectively）.The level of serum resistin in obese type 2 DM group was statistically higher than that of non-obese type 2 DM group（P0.01 ）.A significantly higher concentration of serum FFA was observed in obese type 2 DM group in comparison to non-obese type 2 DM and the control group （all P0.01）.Multivariate stepwise regression analysis demonstrated that the level of resistin was influenced by the HOMAIR and WHR.Conclusion It is showed that the level of serum resistin was significance higher in elderly type 2 DM patients, especially in obesity cases.The HOMA-IR and WHR were the important factors to influence the level of resistin.In conclusion, the resistin may play an important role in insulin resistance,obesity and diabetes mellitus.