新诊断2型糖尿病患者血清BNP及Ghrelin水平与IR的关系及意义

Relationship between serum BNP and ghrelin levels and insulin resistance in newly diagnosed Type 2 diabetic patients

目的:探讨新诊断2型糖尿病(T2DM)患者血清脑钠肽(BNP)与生长激素释放肽(Ghrelin)的表达水平及二者与胰岛素抵抗(IR)的关系。方法:选取新诊断T2DM患者40例作为2型糖尿病(T2DM)组,同期体检健康者40例作为正常对照(NC)组。收集两组一般资料及其它实验室检测指标,采用酶联免疫吸附(ELISA)法检测血清BNP及Ghrelin水平,计算胰岛素抵抗指数(HOMA-IR)、胰岛素敏感性指数(ISI)、胰岛素β细胞功能指数(HOMA-β),并分析各指标之间的关系。结果:(1)T2DM组患者血清BNP和Ghrelin水平均低于NC组,差异有统计学意义(P<0.05)。(2)Spearman秩相关分析显示:BNP和Ghrelin分别与HOMA-IR、体质指数(BMI)、空腹胰岛素(FINS)、空腹血糖(FPG)、总胆固醇(TC)呈负相关(P<0.05),与ISI、高密度脂蛋白胆固醇(HDL-C)呈正相关(P<0.05),且BNP与Ghrelin呈正相关(P<0.01)。(3)多元逐步回归分析显示:Ghrelin和FPG为影响BNP的最显著因素(β值分别为1.392和-2.282,P<0.05),常数项为23.316;BNP和FPG为影响Ghrelin的最显著因素(β值分别为0.141和-0.827,P<0.05),常数项为20.758。结论:新诊断T2DM患者血清BNP和Ghrelin均明显减低,且二者呈正相关。BNP和Ghrelin可能在2型糖尿病及IR的发生发展中存在通路,并为2型糖尿病的早期预防、诊断及治疗提供新方向。

Objective:To explore the relationship between serum brain natriuretic peptide(BNP)and ghrelin levels and insulin resistance in newly diagnosed type 2 diabetes mellitus(T2DM)patients.Methods:Forty newly diagnosed T2DM patients(T2DM group)and forty healthy people(NC group)of the First Affiliated Hospital of Jiamusi University from October 2014 to May 2015 were chosen.The general data and other observation indexes of the two groups were collected.The levels of serum BNP and Ghrelin by enzyme-linked immunosorbent assay(ELISA)were detected.The insulin resistance index(HOMA-IR),insulin sensitivity index(ISI),pancreaticβcell function index(HOMA-β)were calculated.The relationship among BNP、Ghrelin、IR and other indexes were tested by single factor Spearman relevant analysis and multiple stepwise regression analysis.Results:①The serum BNP and Ghrelin levels in T2DM group were significant lower than in NC group(P<0.05).②The single factor Spearman relevant analysis showed that serum BNP and Ghrelin were both negatively correlated with HOMA-IR,body mass index(BMI),FINS,fasting plasma glucose(FPG)and total cholesterol(TC)(P<0.05);and positively related with ISI and high-density liporotein cholesterol(HDL-C)(P<0.05).BNP was positively related with Ghrelin(P<0.01).③Multiple stepwise regression analysis showed that Ghrelin and FPG were the most significant factors for BNP(β=1.392,-2.282;P<0.05),constant term=23.316;BNP and FPG were the most significant factors for Ghrelin(β=0.141,-0.827;P<0.05),constant term=20.758.Conclusion:BNP and Ghrelin were positively correlated with each other;and both have significant decrease in T2DM group.BNP and Ghrelin may be involved in the occurrence and development of T2DM and IR by a common way together,which provides a new direction for early prevention,diagnosis and treatment of type 2 diabetes mellitus.