血清抵抗素和游离脂肪酸水平与血糖水平关系的比较

Comparison of relationship between serum resistin level, free fatty acid level and plasma glucose level

目的 :比较高血压病患者血清抵抗素和游离脂肪酸 (FFA)水平与血糖的关系。 方法 :71例高血压病患者行口服葡萄糖耐量试验 (OGTT)和胰岛素释放试验 ,己糖激酶法测定血糖浓度、放射免疫法测定血清胰岛素浓度 ,将所有患者分为 3组 :2型糖尿病 (DM)组 1 8例 ,糖耐量低减 (IGT)组 2 6例 ,正常糖耐量 (NGT)组 2 7例。计算 3组患者葡萄糖曲线下面积(AU CG)和 OGTT开始后 30 min胰岛素和血糖变化的比值 (Δ I30 /Δ G30 ) ,根据 Cederholm公式计算胰岛素敏感指数 (ISI) ,并采用酶免疫测定法测定空腹血清抵抗素水平 ,铜试剂显色法测定 FFA水平。 结果 :DM组空腹血清抵抗素浓度为 (2 9.8±1 2 .1 ) μg/L,显著高于 NGT组的 (2 2 .0± 8.4 ) μg/L (P<0 .0 5 ) ,略高于 IGT组的 (2 5 .1± 1 0 .4 ) μg/L;空腹血清抵抗素浓度与 AU CG呈显著正相关 (P<0 .0 0 1 ) ,与 ISI及 ΔI30 /Δ G30 呈显著负相关 (P<0 .0 5 )。 DM组空腹血清 FFA浓度为 (1 0 4 8.7±4 81 .6 ) μm ol/L,显著高于 IGT组的 (74 4 .5± 31 3.3) μm ol/L 和 NGT组的 (71 5 .3± 32 7.5 ) μmol/L (P<0 .0 5 ) ,FFA浓度与AU CG 呈显著正相关 (P<0 .0 5 ) ,与 ISI呈显著负相关 (P<0 .0 5 ) ,与 ΔI30 /ΔG30 无相关 ;多元回归分析表明抵抗素浓度影?

Objective:To compare the relationship between serum resistin level,free fatty acid (FFA) level,and plasma glucose levels.Methods: Fasting serum concentrations of resistin and FFA were measured in 71 hypertension patients [including 18 cases with type 2 diabetes mellitus(DM),26 impaired glucose tolerance (IGT),27 normal glucose tolerance (NGT)].Oral glucose tolerance test and insulin release test were performed in all cases for calculating glucose area under the curve (AUC G),the ratio of insulin change to glucose change during the first 30 min after glucose ingestion (ΔI 30 /ΔG 30 ) and insulin sensitivity index (ISI) according to Cederholm' formula. Results: Fasting serum resistin concentration(μg/L) in DM group(29.8±12.1) were higher than that in NGT group(22.0±8.4)( P <0.05) and in IGT group (25.1±10.4).Pearson analysis showed that fasting serum resistin concentrations were correlated with AUC G( r =0.380, P <0.001), ISI ( r =-0.242, P < 0.05) and ΔI 30 /ΔG 30 ( r =-0.298, P <0.05).Fasting serum FFA concentration(μmol/L) in DM group(1 048.7±481.6) were higher than that in IGT group(744.5±313.3, P <0.05) and in NGT group (715.3±327.5, P <0.05).Pearson analysis showed that fasting serum FFA concentrations were correlated with AUC G( P <0.05) and ISI ( P <0.05),but not correlated with ΔI 30 /ΔG 30 . A multiple linear regression analysis showed that resistin had a more important effect on AUC G than on FFA.Conclusion: Both resistin and FFA are correlated with glucose metabolism,but resistin may be more closely correlated with glucose metabolism than FFA in essential hypertension patients.