1型糖尿病患者血清内脂素水平变化及其临床意义的研究

The changes and clinical significance of serum visfatin levels in patients with type 1 diabetes mellitus

目的观察T1DM患者血清内脂素(visfatin)水平的变化,探讨其与T1DM患者糖脂代谢的相关性。方法采用ELISA测定31例T1DM患者、33例T2DM患者和30名健康者(NC)血清visfatin水平,同时测定FPG、FIns、TG、TC、HDL-C、LDL-C及HbA_1 c,计算WHR、BMI及胰岛β细胞功能指数(HOMA-β3)。结果 T1DM组血清visfatin水平较NC组和T2DM组减低,且T2DM组高于NC组[(96.4±52.0)vs(138.3±66.9)vs(205.7±82.2)pg/ml,P<0.05]。T1DM组血清visfatin水平与BMI、WHR、FIns、HOMA-3呈正相关(r=0.351、0.591、0.528、0.557,P均<0.01)。多元逐步回归分析显示,WHR、HOMA-β是T1DM患者visfatin水平的独立相关因素。结论 T1DM患者血清visfatin水平降低可能与WHR和HOMA-β降低有关。

Objective To investigate the changes of the serum visfatin levels in patients with type 1diabetes mellitus（T1DM）,type 2 diabetes mellitus（T2DM） and normal control,and to explore the relationship between visfatin and glucose and lipid metabolism.Methods A total of 94 subjects were divided into 3 groups：31 cases of T1DM（T1DM group）,33 T2DM（T2DM group）,and 30 normal control（NC group）.The serum visfatin levels were assayed with ELISA.FPG,2 hPG,FIns,2 hIns,TG,TC,HDL-C,LDL-C and HbA1 c were determined respectively.WHR,BMI,HOMA-IR and HOMA-β were calculated.Results（1） Compared with NC group and T2 DM group,the serum visfatin levels of T1 DM group significantly reduced[（96.4 ± 52.0） vs（138.3 ± 66.9） vs（205.7 ± 82.2） pg/ml,P〈0.05].However,the levels of visfatin in T2 DM group were significantly higher than in NC group（P〈0.01）.（2）In T1 DM group,serum visfatin levels were positively correlated with BMI,WHR,FIns and HOMA-β（r=0.351,0.591,0.557 and 0.528,all P〈0.01）.（3） Multivariable logistic regression analysis showed that WHR and HOMA-β were independent risk factors of visfatin.Conclusion The lower serum visfatin levels in T1 DM group may be associated with WHR and islet beta cell function.