空腹血清游离脂肪酸与2型糖尿病的关系

The relationship of fasting serum free fatty acid and type 2 diabetes mellitus

目的 2型糖尿病(T2DM)患者血清游离脂肪酸(FFA)水平的变化及与糖代谢、胰岛素抵抗各指标间的相关性,并探讨影响T2DM的危险因素。方法通过口服糖耐量试验(OGTT)筛选105例未经药物治疗的T2DM患者和66名健康人(正常对照组),分别测定其血浆葡萄糖(PG)和胰岛素(Ins)水平,计算胰岛素抵抗指数(HOMA-IR)和胰岛素分泌指数(HOMA-IS),同时检测空腹血清FFA。对血清FFA浓度与性别、年龄、体重、体重指数(BMI)、0～3 h PG和Ins以及HOMA-IR、HOMA-IS进行相关性分析。以T2DM是否发病为因变量Y(T2DM组=1,正常对照组=0),性别、年龄、体重、BMI、HOMA-IR、HOMA-IS和FFA为自变量,做Logistic回归分析。结果 T2DM组HOMA-IR、HOMA-IS和血清FFA水平与正常对照组比较差异均有统计学意义(P<0.01、P<0.001)。相关分析发现,空腹血清FFA与0 h PG、0.5 h PG、1 h PG、2 h PG、3 h PG、3 h Ins、HOMA-IR呈弱正相关(r分别为0.340、0.281、0.282、0.307、0.302、0.193、0.225,P均<0.05)。Logistic回归分析显示血清FFA是T2DM的重要风险因素[OR=14.05,95%可信区间(CI):1.87～105.55]。结论血清FFA水平升高可能影响机体糖动态平衡,与胰岛素抵抗和T2DM发病密切相关。

Objective To investigate the correlation of serum free fatty acid （FFA） levels in patients with type 2 diabetes mellitus（T2DM） with the parameters of glucose metabolism and insulin resistance, and study the risk factors of T2DM. Methods A total of 105 patients with T2DM and 66 healthy controls （ normal control group） were screened and classified into 2 groups by oral glucose tolerance test （OGTT）. The plasma glucose （PG） , serum insulin （Ins） and fasting serum FFA were measured. The HOMA-insulin resistance index （HOMA-IR） and HOMA-insulin secretion index （HOMA-IS） were calculated. The correlations of serum FFA with sex, age, weight,body mass index（BMI） ,0-3 h PG and Ins, HOMA-IR and HOMA-IS were analyzed. Logistic regression analysis was used with sex, age, weight, BMI, HOMA-IR, HOMA-IS and FFA to define the independent risk factors of T2DM, and variance Y was according to T2DM group = 1 and normal control group = 0. Results HOMA-IR, HOMA-IS and fasting serum FFA had significant difference between T2DM group and normal control group （ P 〈 0. 01, P 〈 0. 001 ）. The correlation analysis showed that fasting serum FFA level was positively correlated with 0 h PG, 0.5 h PG, 1 h PG, 2 h PG, 3 h PG, 3 h Ins and HOMA-IR （r =0. 340, 0. 281, 0. 282, 0. 307, 0. 302, 0. 193 and 0. 225, P 〈0.05）. The Logistic regression analysis showed that fasting serum FFA level was the important risk factor of T2DM[ odd ratio （OR） = 14.05, 95% confidence interval （CI） ： 1.87-105.55 ]. Conclusions The increasing of fasting serum FFA level may be related to glucose homeostasis, insulin resistance and T2DM development.