不同糖耐量水平人体的脂联素、内皮素-1与胰岛素抵抗的相关性

目的探讨不同糖耐量水平人体的脂联素(APN)和内皮素-1(ET-1)与胰岛素抵抗的关系。方法选择70例正常对照(对照组)、55例糖耐量受损(IGT组)和65例新诊断早期2型糖尿病患者(T2DM早期组),测定受试者空腹状态下的血清空腹血糖(FPG)、空腹胰岛素(FINS)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血清APN、血浆ET-1及服糖后2 h血糖水平;测量身高、体重,计算体质指数(BMI);计算胰岛素抵抗指数(HOMA-IR)。结果 IGT组、T2DM早期组分别与正常对照组相比,HOMA-IR、ET-1、LDL均显著升高,而APN、HDL均显著降低,T2DM早期组更明显(均P0.01)。血清APN水平与HOMA-IR、BM(I体重指数)、FBG、LDL显著负相关,与HDL显著正相关(P0.01)。血浆ET-1与HOMA-IR、BMI、FBG、LDL显著正相关,与HDL显著负相关(P0.01)。APN与ET-1显著负相关(r=-0.517,P0.01)。结论人体血清APN和血浆ET-1的水平与胰岛素抵抗、体重指数、脂代谢均密切相关。APN和ET-1水平可作为2型糖尿病发病危险性和疾病进展的预测指标。

Correlation of Insulin Resistance with Adiponectin and Endothelin-1 in People with Different Levels of Glucose Tolerance

Objective To assay the levels of adiponectin（APN） and endothelin-1（ET-1） in people with different levels of glucose tolerance,and to discuss the correlation of insulin resistance（IR） with APN and ET-1.Methods 70 controls（control group）,55 patients with impaired glucose tolerance（IGT group） and 65 patients with type 2 diabetes（T2DM group） were selected and examined the levels of serum APN,FBG,FINS,TG,HDL,LDL and plasma ET-1 in the condition of empty stomach,and examined the levels of serum blood glucose of OGTT 2h.Their body mass index（BMI） and HOMA-IR were calculated.Results Compared with control group,the levels of HOMA-IR,ET-1,LDL were all significantly increased in IGT group and T2DM group,and the levels of APN and HDL were all significantly decreased（P〈0.01）,especially in T2DM group;Serum APN level was negatively correlated with the levels of HOMA-IR,BMI,FBG and LDL,and positively correlated with HDL level（P〈0.01）.Plasma ET-1 level was positively correlated with the levels of HOMA-IR,BMI,FBG and LDL,and negatively correlated with HDL level（P〈0.01）.APN level was negatively correlated with ET-1 level（P〈0.01）.Conclusion The levels of serum APN and plasma ET-1 were intimately correlated with insulin resistance,body mass index and blood-fat metabolism;and the levels of serum APN and plasma ET-1 are one of the risk factors in the development of type 2 DM.