T2DM患者腹内脂肪含量与胰岛素信号转导、脂代谢特征、脂肪细胞因子分泌的相关性

Correlation of visceral adipose tissue content with insulin signal transduction,lipid metabolism features and adipocytokine secretion in patients with T2DM

目的:研究2型糖尿病(T2DM)患者腹内脂肪含量与胰岛素信号转导、脂代谢特征、脂肪细胞因子分泌的相关性。方法:选择2015年3月~2018年2月在我院首次诊断为T2DM的患者作为T2DM组,同期体检的健康者作为对照组,对T2DM组患者进行腹内脂肪含量CT扫描并分为VAT≥100cm^2患者、VAT<100cm^2患者。采集两组的空腹外周血并测定空腹胰岛素(F-Ins)、脂代谢指标、脂肪细胞因子,计算HOMA-IR、ISI。结果:T2DM组的F-Ins、HOMA-IR水平以及低密度脂蛋白胆固醇(LDL-C)、脂蛋白B(Apo-B)、游离脂肪酸(FFA)、瘦素(LP)、视黄醇结合蛋白4(RBP4)含量与对照组比较显著升高,ISI水平以及高密度脂蛋白胆固醇(HDL-C)、脂蛋白A(Apo-A)、脂联素(APN)、网膜素-1(Omentin-1)含量与对照组比较显著降低;T2DM组中VAT≥100cm^2患者的F-Ins、HOMA-IR水平以及LDL-C、Apo-B、FFA、LP、RBP4含量高于VAT<100cm^2患者,ISI水平以及HDL-C、Apo-A、APN、Omentin-1含量低于VAT<100cm^2患者。结论:T2DM患者腹内脂肪含量升高能够加重胰岛素抵抗、引起脂代谢及脂肪细胞因子分泌紊乱。

Objective： To study the correlation of visceral adipose tissue content with insulin signal transduction, lipid metabolism features and adipocytokine secretion in patients with type 2 diabetes mellitus （T2DM）. Methods： The patients who were first diagnosed as T2DM in our hospital between March 2015 and February 2018 were selected as the T2DM group, and the healthy subjects who underwent physical examination during the same period were selected as the control group. The T2DM group underwent visceral adipose tissue content scanning and were divided into those with VAT≥100 cm 2 and those with VAT〈100 cm 2. Fasting peripheral blood was collected from the two groups to measure the F-Ins, lipid metabolism indexes and adipocytokines and calculate the HOMA-IR and ISI. Results： F-Ins and HOMA-IR levels as well as LDL-C, Apo-B, FFA, LP and RBP4 contents of T2DM group were significantly higher than those of control group whereas ISI level as well as HDL-C, Apo-A, APN and Omentin-1 contents was significantly lower than those of control group （ P 〈0.05）; F-Ins and HOMA-IR levels as well as of LDL-C, Apo-B, FFA, LP and RBP4 contents of T2DM group of patients with VAT≥100cm 2 were higher than those of patients with VAT〈100 cm 2 whereas ISI level as well as HDL-C, Apo-A, APN and Omentin-1 contents was lower than those of patients with VAT〈100 cm 2 （ P 〈0.05）. Conclusion： The increase of visceral adipose tissue content in patients with T2DM can aggravate the insulin resistance and cause the disorder of lipid metabolism and adipocytokine secretion.