初发糖尿病患者血清鸢尾素水平变化及意义

Changes in levels of serum irisin in patients with new-onset diabetes mellitus

目的观察初发糖尿病患者血清鸢尾素水平变化及其与代谢参数的关系,并探讨其意义。方法初发糖尿病患者58例、糖耐量正常者64例,采用ELISA试剂测定血清鸢尾素,采用Spearman相关性分析鸢尾素水平与代谢参数(BMI、体脂肪量、体脂比、空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹胰岛素、胰岛素分泌指数、胰岛素抵抗指数、胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、游离脂肪酸)的关系,采用Logistic回归分析鸢尾素水平与糖尿病的关系。结果初发糖尿病、糖耐量正常者血清鸢尾素水平分别为238.03(198.97,279.43)、286.48(241.88,355.19)ng/m L,两者相比P<0.01。血清鸢尾素水平与空腹血糖(r=-0.246,P<0.01)、餐后2 h血糖(r=-0.298,P<0.01)、游离脂肪酸(r=-0.199,P<0.05)呈负相关,与高密度脂蛋白胆固醇(r=0.254,P<0.01)呈正相关。血清鸢尾素水平与糖尿病发生呈负相关关系(OR=0.994,95%CI:0.990~0.998,P=0.005)。结论初发糖尿病患者血清鸢尾素水平降低。血清鸢尾素水平与糖尿病发生呈负相关。

Objective To investigate the changes in levels of serum irisin in patients with new-onset diabetes mellitus （DM） and its association with various metabolic parameters. Methods Fifty-eight patients with new-onset DM （DM group） and 64 people with normal glucose tolerance （NGT group） were selected. Serum ifisin was detected by ELISA and its associations with metabolic parameters [body mass index （BMI）, body fat mass, body fat percentage, fasting plasma glucose （FPG）, 2 h post-load plasma glucose （2 h PG） , Hemoglobin A1c, fasting insulin, homeostasis model assessment- 13 value, insulin resistance index, total cholesterol, triglyceride, high-density lipoprotein cholesterol （HDL-C）, low-densi- ty lipoprotein cholesterol （LDL-C） and free fatty acids （FFA） ] were analyzed by Spearman bivariate correlation. Logistic regression analysis was performed to assess the association between irisin level and DM. Results The serum irisin levels in the DM group and NGT group were 238.03 （ 198.97,279.43 ） and 286.48 （241.88,355.19） ng/mL, respectively （P 〈 0.01）. Serum irisin level was negatively correlated with FPG （r = -0. 246, P〈0. 01）, 2 h PG （r = -0. 184, P 〈 0.05）, FFA （r = -0. 199, P 〈0.05） and was positively correlated with HDL-C （r =0. 254,P 〈0.01 ）. Serum irisin lev- el was negatively correlated with DM （ OR = 0. 994, 95 % CI：0. 990 - 0. 998, P = 0. 005）. Conclusion Serum irisin level is significantly decreased in patients with new-onset DM, which is negatively correlated with DM.