新诊断2型糖尿病患者腹部内脏脂肪与血清chemerin水平、胰岛素抵抗的相关性研究

Relationship betwen Visceral Adipose Tissue and Serum Chemerin Levels as Well as Insulin Resistance in Newly Diagnosed Type 2 Diabetic Subjects

目的:探讨新诊断2型糖尿病患者腹部内脏脂肪与血清chemerin水平、胰岛素抵抗的相关性。方法:选取2017年1月—2018年9月于广州市第一人民医院内分泌科门诊、住院新诊断2型糖尿病患者70例(DM组),按腹部内脏脂肪(VAT)100 cm^2分为腹型肥胖组(DM-ob组,37例)及非腹型肥胖组(DM-nonob组,33例),另选取健康体检者30例(NC组)。采用ELISA测定各组血清chemerin水平,同时检测血糖、糖化血红蛋白、血脂、FINS等指标,稳态模型评估胰岛素抵抗指数。CT扫描平脐平面测量腹部内脏脂肪及皮下脂肪面积。结果:DM-ob组SBP、DBP、BMI、WC、FINS、HOMA-IR、LDL-C、VAT、SAT、chemerin均高于DM-nonob组(P<0.05),HDL-C低于DM-nonob组(P<0.05)。相关分析显示,VAT与BMI、WC、SBP、DBP、FINS、HOMA-IR、LDL-C、chemerin均呈正相关(r=0.284、0.326、0.375、0.417、0.512、0.213、0.431、0.425,P<0.05),与HDL-C呈负相关(r=-0.368,P<0.05)。多元回归分析发现chemerin、WC为腹部内脏脂肪的独立影响因素。结论:新诊断2型糖尿病腹型肥胖患者存在胰岛素抵抗、血脂紊乱,腹部内脏脂肪与chemerin相关,联合WC及chemerin的测定可能会对腹型肥胖预测更精准。

Objective:To investigate the relationship between visceral adipose tissue and serum chemerin as well as insulin resistance in newly diagnosed type 2 diabetes subjects.Method:A total of 70 newly diagnosed T2DM subjects(DM group)enrolled from January 2017 to September 2018 in our hospital were selected,according to VAT 100 cm^2,the patients were divided into abdominal obesity group(DM-ob group,37 cases)and non-abdominal obesity group(DM-nonob group,33 cases),and 30 healthy subjects were selected(NC group).ELISA was used to determine the serum chemerin level of each group,and at the same time,the blood glucose glycosylated hemoglobin,blood lipid,FINS and other indexes were detected,and the steady-state model was used to evaluate the insulin resistance index.The area of visceral fat and subcutaneous fat in the abdomen was measured by CT scanning in the plane of umbilicus.Result:SBP,DBP,BMI,WC,FINS,HOMA-IR,LDL-C,VAT,SAT,chemerin in DM-ob group were higher than those in DM-nonob group(P<0.05),HDL-C was lower than that in DM-nonob group(P<0.05).Positive correlations were found between VAT and BMI,WC,SBP,DBP,FINS,HOMA-IR,LDL-C,chemerin(r=0.284,0.326,0.375,0.417,0.512,0.213,0.431,0.425,P<0.05),while a negative correlation was found between VAT and HDL-C(r=-0.368,P<0.05).Moreover,chemerin,WC were independent predictive factor of VAT.Conclusion:The newly diagnosed type 2 diabetic patients with abdominal obesity have insulin resistance and dyslipidemia,visceral adipose tissue is corelated with chemerin,combination of WC and chemerin may predict abdominal obesity more accurately.