肥胖合并2型糖尿病患者游离脂肪酸、同型半胱氨酸的水平及其临床意义

Clinical significance of free fatty acids and homocysteine in obese patients with type 2 diabetes mellitus

目的探讨游离脂肪酸(FFA)、同型半胱氨酸(Hcy)在肥胖合并2型糖尿病(T2DM)患者血液中的变化规律及其临床意义。方法将门诊体检者125例作为研究对象,分为肥胖合并2型糖尿病(T2DM)组40例,单纯肥胖组43例,正常组42例。检测血脂、血糖、胰岛素、FFA、Hcy等指标,观察FFA、Hcy在不同人群中的变化规律,并分析其与胰岛素抵抗指数及胰岛β细胞分泌指数的相关性。结果 3组间甘油三酯比较,肥胖合并T2DM组>单纯肥胖组>正常组(P<0.05)。肥胖合并T2DM组中FBG、2 hPBG、FINS、HOMA-β、HOMA-IR、FFA、Hcy分别与单纯肥胖组及正常组水平比较,差异有统计学意义(P<0.05)。FFA与HOMA-IR呈正相关(r=0.821,P<0.05),与HOMA-β呈负相关(r=-0.314,P<0.05)。Hcy与HOMA-IR呈正相关(r=0.715,P<0.05),与HOMA-β呈负相关(r=-0.451,P<0.05)。结论肥胖合并2型糖尿病患者体内FFA、Hcy水平较高。FFA、Hcy与胰岛素抵抗及胰岛β细胞功能密切相关。

Objective To investigate the changes of free fat acid(FFA)and Homocysteine acid(HCY)in the blood of obese patients with type 2 diabetes mellitus(T2 DM)and their clinical significance.Methods A total of 120 healthy people were selected and divided into three groups:obesity with T2 DM group(n=40),simple obesity group(nv=43)and normal group(n=42).Blood lipid,blood glucose,insulin,FFA and Hcy were measured.The changes of FFA and Hcy in different crowd were observed,and the correlation of FFA and Hcy with insulin resistance index and islet cell secretion index was analyzed.Results Comparing with the normal group,the obesity group with DM was triglyceride than the simple obesity group(P<0.05).The levels of FBG,2 hPBG,FINS,HOMA-β,HOMA-IR,FFA and Hcy in obesity group were significantly higher than those in simple obesity group and normal group(P<0.05).FFA was positively correlated with HOMA-IR(r=0.821,P<0.05)and negatively correlated with HOMA-β(r=-0.314,P<0.05).HCY was positively correlated with HOMA-IR(r=0.715,P<0.05)and negatively correlated with HOMA-β(r=-0.451,P<0.05).Conclusion The levels of FFA and Hcy in obese patients with T2 DM are higher.FFA and HCY are closely related to insulin resistance and islet cell function.