肥胖2型糖尿病患者血清几丁质酶3样蛋白1水平与胰岛素抵抗指数及糖化血红蛋白关系的研究

Relationship between serum YKL-40 and insulin resistance index and glycosylated hemoglobin in obese patients with type 2 diabetes mellitus

目的探讨肥胖T2DM患者血清几丁质酶3样蛋白1(YKL⁃40)水平与胰岛素抵抗指数(HOMA⁃IR)及HbA1c的关系。方法选取2017年5~12月于我院内分泌科住院的120例T2DM患者,根据BMI分为≥28 kg/m2的肥胖T2DM组(OB组)及<28 kg/m2的非肥胖T2DM组(T2DM组),每组各60例。比较两组血清YKL⁃40、HOMA⁃IR及HbA1c水平;Logistic回归分析血清YKL⁃40水平与HOMA⁃IR和HbA1c的关系。结果与T2DM组比较,OB组血清YKL⁃40、HbA1c、HOMA⁃IR升高(P<0.01);Pearson相关性分析显示,血清YKL⁃40水平与HOMA⁃IR及HbA1c呈正相关(r=0.968、0.989,P<0.01);多元线性回归分析显示,HOMA⁃IR及HbA1c是血清YKL⁃40的影响因素(P<0.01)。结论肥胖T2DM患者血清YKL⁃40水平升高。血清YKL⁃40水平与HOMA⁃IR及HbA1c相关,是肥胖T2DM患者的独立危险因素。

Objective To study the relationship between serum chitinase 3⁃like protein 1(YKL⁃40)and insulin resistance index(HOMA⁃IR)and glycosylated hemoglobin(HbA1c)in obese patients type 2 dia⁃betes(T2DM).Methods From May 2017 to December 2017,120 T2DM patients were divided into obese group(OB,BMI≥28 kg/m2)and non⁃obese group(T2DM,BMI<28 kg/m2)with 60 cases in each group.HOMA⁃IR index was calculated.The levels of serum YKL⁃40 and HbA1c were detected and com⁃pared between the two groups.Logistic regression analysis was used to analyze the relationship between serum YKL⁃40 and HOMA⁃IR and HbA1c.Results Compared with T2DM group,the levels of YKL⁃40,HbA1c and HOMA⁃IR index in OB group were significantly higher(P<0.01).Correlation analysis showed that YKL⁃40 was positively correlated with HOMA⁃IR and HbA1c in obese type 2 diabetic patients(r=0.968,0.989,P<0.01).Multiple linear regression analysis showed that HbA1c and HOMA⁃IR were the in⁃fluencing factors of serum YKL⁃40(P<0.01).Conclusion Serum YKL⁃40 levels are high and associat⁃ed with HOMA⁃IR and HbA1c in T2DM patients with obesity,which may be a risk factor for obese T2DM.