2型糖尿病周围神经病变患者血清网膜素1水平与胰岛素抵抗相关性的研究

Association between serum Omentin-1 and insulin resistance in patients with type 2 diabetic peripheral neuropathy

目的观察血清网膜素1(Omenin-1)水平与糖尿病周围神经病变(DPN)患者TNF-α、C-RP和IL-6、葡萄糖代谢率(Rd)的相关性,探讨Omenin-1在DPN发生发展中可能的作用机制。方法选取2016年6月至2018年4月于南京医科大学康达学院第一附属医院内分泌科住院的T2DM患者52例,根据是否合并DPN分为单纯T2DM组(T2DM,n=22)和合并DPN组(DPN,n=30)。另选取同期本院健康体检者8名为正常对照(NC)组。采用双抗体夹心ELISA法检测各组Omentin-1水平,行高胰岛素-正葡萄糖钳夹试验,计算Rd。结果NC、T2DM、DPN三组SBP、FPG、HbA1c、TNF-α、IL-6依次升高(P<0.05),Omentin-1依次降低(P<0.05)。与NC组比较,T2DM、DPN组C-RP升高(P<0.05),Rd降低(P<0.05)。Pearson相关分析显示,Omentin-1表达水平与HDL-C、Rd呈正相关(r=0.27、0.68,P<0.05),与HbA1_c、TNF-α、IL-6呈负相关(r=-0.66、-0.62、-0.55,P<0.05)。多元线性逐步回归显示,IL-6、Rd是Omentin-1的影响因素。结论Omenin-1可能通过炎症反应、IR参与DPN发生发展。

Objective To explore the possible pathogenesis of Omentin 1 in the development of DPN by investigating the correlation between serum Omentin1 levels and TNFα,CRP,IL6 and insulinmediated glucose disposa(lRd).Methods A total of 52 patients with type 2 diabetes mellitus(T2 DM)who were hospitalized in the Department of Endocrinology,Kangda College First Affiliated Hospital of Nanjing Medical University from June 2016 to April 2018 were enrolled in this study.They were divided into simple T2 DM group(T2 DM,n=22)and combined DPN group(DPN,n=30)according to whether they had diabetic peripheral neuropathy(DPN).In addition,8 healthy people in our hospital were selected as normal control group(NC).The level of Omentin1 was detected by double antibody sandwich ELISA in each group.Hyperinsulinemicglucose clamp test was performed,and Rd was calculated.Results SBP,FPG,HbA1 c,TNFαand IL6 increased in turn(P<0.05),while Omentin1 decreased in turn(P<0.05)in NC,T2 DM and DPN groups.CRP was higher and Rd was lower in T2 DM and DPN groups than in NC group(P<0.05).Pearson correlation analysis showed that the expression level of Omentin1 was positively correlated with HDLC and Rd(r=0.27,0.68,P<0.05),but negatively correlated with HbA1 c,TNFαand IL6(r=-0.66,-0.62,-0.55,P<0.05).The multiple linear stepwise regression analysis showed that IL6 and Rd were influencing factors for Omentin1.Conclusion Omenin1 might be involved in DPN development through inflammatory reaction and IR.