2型糖尿病患者血清鸢尾素水平与胰岛素抵抗的相关性

Serum irisin level and its correlation with insulin resistance in patients with type 2 diabetes

目的 探讨血清鸢尾素（irisin）水平与胰岛素抵抗是否存在相关性.方法 选取2013年6月至2014年1月在浙江大学医学院附属第一医院内分泌科2型糖尿病（T2DM）住院患者82例（男48例,女34例）为T2DM组,同期体检中心健康体检者62名（男33名,女29名）为对照组（NC组）.所有受试者均接受体格检查、生化指标和血清irisin水平检测,T2DM组加测空腹胰岛素（FINS）、餐后血糖.采用Studentt检验、Pearson相关分析和多元线性回归进行统计学分析.结果 T2DM组血清irisin浓度明显低于NC组[（1.5±0.6）比（2.6±0.6）ng/L,t=-10.233,P＜0.05];且经Pearson相关分析,T2DM组血清irisin浓度与腰臀比（WHR）、餐后2h血糖、稳态模型胰岛素抵抗指数（HOMA-IR）呈负相关（r=-0.603、-0.295、-0.22,均P＜0.05）;与病程、性别、年龄、是否吸烟、是否存在并发症、是否存在合并症、体质指数（BMI）、收缩压、舒张压、空腹血糖（FBG）、糖化血红蛋白（HbA1c）、FINS、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、甘油三酯（TG）、动脉粥样硬化指数（AI）无明显相关性（均P＞0.05）;进一步用多元线性回归分析发现,在排除性别、年龄、血压、并发症、合并症后,血清irisin水平与WHR呈显著负相关,WHR是血清irisin水平独立的负性影响因子（标准化回归系数=-3.995,P＜0.05）.结论 T2DM患者血清irisin水平较正常人减低,并与胰岛素抵抗的发生发展有关.

Objective To investigate the association between serum irisin and insulin resistance.Methods Eighty two subjects with type 2 diabetes mellitus（T2DM） were selected from in-patients in Department of Endocrinology,the First Affiliated Hospital,Zhejiang University School of Medicine （including 48 men and 34 women） as type 2 diabetes group,and 62 control subjects （NC） were selected from healthy people in medical centre （including 33 men and 29 women） as normal control group.Anthropometric indexes,metabolic parameters and serum irisin levels were measured in all subjects.Fasting insulin （FINS）,postprandials blood glucose was measured in T2DM group.The data were analyzed using student-t test,Pearson correlation analysis and multiple linear regression analysis.Results Serum irisin levels were significantly decreased in T2D group compared with NC group（（1.5 ±0.6）vs （2.6±0.6） ng/L,t=-10.233,P＜0.05）.Pearson correlation analysis showed serum irisin levels in T2DM group were inversely associated with waist hip ratio （WHR）,2 hour-postprandial blood glucose and homeostasis model assessment of insulin resistance （HOMA-IR） （r=-0.603,-0.295,-0.22,P＜0.05）.Other clinical parameters,including disease duration,gender,age,smoking habit,diabetic complications,other complications,body mass index （BMI）,systolic blood pressure,diastolic blood pressure,fasting blood glucose （FBG）,glycated hemoglobin A1c （HbA1c）,FINS,high density lipoprotein cholesterol （HDL-C）,low density lipoprotein cholesterol （LDL-C）,serum total cholesterol （TC）,total triglycerides （TG） and atherosclerosis index （AI）,were not correlated with irisin levels （P＞0.05 all above）.Multiple linear regression analysis showed that after adjusting for gender,age,blood pressure,diabetic complications and other complications,WHR was significantly negatively associated with serum irisin levels,and WHR was the negative independent determinant of serum irisin （standardized regression coefficient =-3.995,P＜0.05）.Conclusion Serum irisin levels are decreased in patients with T2DM and associated with the development of insulin resistance.