中青年2型糖尿病患者颗粒蛋白前体、脂联素水平及其比值与胰岛素抵抗的相关性分析

Analysis of the correlation between granule protein precursor,adiponectin level and its ratio and insulin resistance in young and middle-aged patients with type 2 diabetes mellitus

目的研究中青年2型糖尿病(T2DM)患者脂联素(ADP)、颗粒蛋白前体(PGRN)水平的变化情况,分析PGRN与ADP比值(PGRN/ADP)与胰岛素抵抗的相关性。方法选取2019年1月至2020年5月来该院内分泌科就诊的20~60岁新近诊断(半年内)的55例T2DM患者作为T2DM组,收集同期在该院体检中心体检糖耐量正常(NGT)且性别、年龄与T2DM组无差异的52例健康体检者作为NGT组。测量两组受试者身高、体质量、血压、腰围(WC)、臀围,并计算体质量指数(BMI)、腰臀比(WHR);检测两组受试者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)、ADP、空腹胰岛素(FINS)、PGRN水平,并计算胰岛素抵抗指数(HOMA-IR)和PGRN/ADP。分析中青年T2DM患者PGRN、ADP水平及PGRN/ADP与胰岛素抵抗的相关性。结果T2DM组收缩压、舒张压、FPG、PGRN/ADP、WHR、BMI、TG、PGRN、HOMA-IR均较NGT组明显增加(P<0.05),ADP水平较NGT组明显下降(P<0.05);PGRN、PGRN/ADP与HOMA-IR均呈正相关(r=0.25、0.52,P<0.05),ADP与HOMA-IR呈负相关(r=-0.36,P<0.05)。多元逐步回归分析显示,PGRN/ADP对HOMA-IR的影响最大(偏回归系数为0.279,标准化偏回归系数为0.472,P<0.05)。结论在中青年T2DM患者中,HOMA-IR与PGRN、PGRN/ADP均呈正相关,与ADP呈负相关,且PGRN/ADP对HOMA-IR影响最大。

Objective To study the changes of adiponectin(ADP)and granule protein precursor(PGRN)levels in young and middle-aged patients with type 2 diabetes mellitus(T2DM),and to analyze the correlation between PGRN and ADP ratio(PGRN/ADP)and insulin resistance.Methods A total of 55 patients with T2DM(within half a year)newly diagnosed in the Department of Endocrinology in the hospital From January 2019 to May 2020 were selected as T2DM group.Meanwhile,52 patients with normal glucose tolerance(NGT)whose gender and age had no difference from T2DM group were collected as NGT group.The height,weight,blood pressure,waist circumference(WC),hip circumference of the two groups were measured,and the body mass index(BMI),waist hip ratio(WHR)was calculated.The total cholesterol(TC),triacylglycerol(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),fasting blood glucose(FPG),adiponectin(ADP),fasting insulin(FINS),granule protein precursor(PGRN)were measured and insulin resistance index(HOMA-IR)and PGRN/ADP were calculated.The correlation between PGRN,ADP level and its ratio and insulin resistance in young and middle-aged patients with T2DM was analyzed.Results Systolic blood pressure(SBP),diastolic blood pressure(DBP),FPG,PGRN/ADP,WHR,BMI,TG,PGRN,HOMA-IR of T2DM group were significantly higher than those of NGT group(P<0.05),and the level of ADP was significantly lower than that of normal group(P<0.05).PGRN,PGRN/ADP were positively correlated with HOMA-IR(r=0.25 and 0.52,P<0.05),and ADP was negatively correlated with HOMA-IR(r=-0.36,P<0.05).Multiple stepwise regression analysis showed that PGRN/ADP had the greatest influence on HOMA-IR(the partial regression coefficient was 0.279,and the normalized partial regression coefficient was 0.472,P<0.05).Conclusion In young and middle-aged patients with T2DM,HOMA-IR is positively correlated with PGRN and PGRN/ADP while it is negatively correlated with ADP,and PGRN/ADP has the greatest influence on HOMA-IR.