肥胖糖尿病患者腹内脂肪含量与脂肪细胞因子、胰岛素抵抗相关性研究

Correlation between intra-abdominal fat content andadipocytokines,insulin resistance in obese patients with diabetes

目的探讨肥胖2型糖尿病患者腹内脂肪含量与脂肪细胞因子、胰岛素抵抗的关系。方法分别检测36名肥胖2型糖尿病患者和20名正常体质量糖尿病患者的腹内脂肪含量、血清脂肪细胞因子(TNF-α、IL-6、瘦素、脂联素)水平及空腹血糖、空腹胰岛素等指标。结果与对照组相比,肥胖组的腹内脂肪含量Homa-IR、TNF-α、IL-6、瘦素显著升高,而脂联素显著降低(P<0.05)。肥胖组患者的腹内脂肪含量与TNF-α、IL-6、瘦素水平正相关,与脂联素水平负相关(P<0.05)。线性回归分析显示腹内脂肪含量是Homa-IR的独立影响因素。结论肥胖糖尿病患者腹内脂肪的积聚可加重胰岛素抵抗,其机制可能部分与腹内脂肪组织分泌的细胞因子有关。

Objective To investigate the correlation between intra-abdominal fat content and adipocytokines,insulin resistance in obese patients with diabetes. Methods The intra-abdominal fat content,levels of serum adipocytokines（ TNF-α、IL-6、leptin and adiponectin）,fasting blood glucose and fasting insulin were detected in 36 obese patients with type 2 diabetes and 20 normal weight patients with type 2 diabetic. Results Compared with the control group,the levels of intra-abdominal fat content,Homa-IR,TNF-α,IL-6 and leptin were significantly higher while the level of adiponectin was significantly lower in obese group（ P〈0. 05）. The intra-abdominal fat content was positively correlation with the levels of TNF-α,IL-6 and leptin,and was negatively correlated with the level of adiponectin in obese group. Linear regression analysis showed that intra-abdominal fat content was the independent factor of Homa-IR. Conclusion In obese diabetic patients,the accumulation of intraabdominal fat can aggravate insulin resistance,and the mechanism may be partly due to the cytokines secreted by intra-abdominal adipose tissue.