血浆内脂素、一氧化氮与2型糖尿病及糖尿病肾病的关系研究

The research on the relativity between plasma visfatin,nitric oxide and type 2 diabetes and diabetic nephropathy

目的:探讨血浆内脂素与一氧化氮(NO)和相关代谢指标的关系,及其在2型糖尿病及糖尿病肾病(DN)发展过程中的作用及关系。方法:选取糖尿病患者72例,其中合并DN(DN组)40例,未合并DN(nDN组)32例,并选取年龄及体重指数(BMI)匹配的正常对照组24名。用酶联免疫法检测血浆内脂素的水平,硝酸还原酶法测定血浆NO水平,同时检测血糖、血脂、胰岛素、C肽、胰岛素原、胰高血糖素、BMI、腰臀比(WHR)、超敏C反应蛋白等相关指标。用胰岛素抵抗指数(HOMA-IR)评价胰岛素抵抗,胰岛素分泌指数评价胰岛β细胞分泌情况,分析各指标间的相关性及与DN的相关性。结果:3组血浆内脂素水平分别为47.46±3.94、50.24±4.93、27.22±4.39,差异有统计学意义(P<0.01)。3组血浆NO水平分别为52.05±6.14、44.05±6.43、61.01±4.76,差异亦有统计学意义(P<0.01)。DN组血浆内脂素浓度与NO、HOMA-IR、空腹胰岛素、腰围、WHR、甘油三酯呈正相关。HOMA-IR、WHR是血浆内脂素的独立影响因素。结论:血浆内脂素、NO与2型糖尿病及合并DN有关。

Objective：To explore the relationships of visfatin,nitric oxide（NO） and the metabolic markers and observe their roles in type 2 diabetes and the development in diabetic nephropathy（DN）.Methods：Seventy-two patients with diabetes,in which 40 patients with diabetic nephropathy and 32 patients without complications were selected,and 24 healthy control cases whose age and body mass index（BMI） matched were also selected.The plasma level of visfatin was measured by enzyme-linked immunosorbent assay,and the level of plasma NO was measured by nitrate reductase method.While blood glucose,blood lipids,insulin,C peptide,proinsulin,glucagon,BMI,waist-hip ratio（WHR）,high sensitivity C-reative protein and other related indicators were also measured.Insulin resistance was evaluated by insulin resistance index the homeostasis model assessment-IR（HOMA-IR）,and insulin secretion index the HOMA-β was used to evaluate β-cell insulin secretion.The correlation between each index and microvascular complications of diabetes and diabetic nephropathy were analyzed.Results：The levels of plasma visfatin were 47.46±3.94,50.24±4.93,and 27.22±4.39 in diabetes cases without DN（nDN）,diabetic cases with DN and control group respectively,and there had statistical differences among the three groups（P〈0.01）;the plasma NO levels were 52.05±6.14,44.05±6.43,61.01±4.76 in diabetic patients nDN,diabetes with DN and control group,which had statistical differences（P〈0.01）.The correlation analysis showed that there had positively correlation with the plasma visfatin level and the concentrations of NO,HOMA-IR,fasting insulin,waist circum ference,WHR,triglyceride in type 2 diabetes.Furtherly,HOMA-IR,WHR were independently associated with visfatin.Conclusions：Plasma visfatin and NO were related with type 2 diabetes and DN.