2型糖尿病患者血清脂肪细胞因子与胰岛素抵抗的相关性研究

目的探讨2型糖尿病患者血清脂肪细胞因子水平变化及其与胰岛素抵抗之间的相关性。方法随机选择30例非肥胖2型糖尿病患者、30例肥胖2型糖尿病患者、30例健康对照者,用酶联免疫吸附法测定血清Resistin、TNF-α、FFA水平,同时测定空腹血糖、糖化血红蛋白、空腹胰岛素、总胆固醇、甘油三酯,测量身高、体重、腰围、臀围及血压,并计算出体重指数(BMI)和腰臀比(WHR),用Homa公式计算胰岛素抵抗指数(IRI),并对它们进行相关分析和逐步回归分析。结果非肥胖糖尿病组和肥胖糖尿病组空腹血浆Resistin、TNF-α、FFA水平均明显高于正常对照组,差异有显著性(P0.05);肥胖糖尿病组的抵抗素、TNF-α、FFA水平与非肥胖糖尿病组,差异有显著意义(P0.05)。肥胖糖尿病组血抵抗素与BMI、FPG、HbA1C、TG呈显著正相关;与IRI呈显著正相关(P0.05),与FINS、TC、SBP、DBP及WHR无相关性。血清TNF-α、FFA水平与BMI、FPG、HbA1C、TG、FINS呈显著正相关(P0.05);与IRI呈显著正相关,与WHR、SBP、DBP无相关。非肥胖2型糖尿病组和对照组抵抗素、TNF-α、FFA与所有因素无明显相关性。多元逐步回归分析结果显示抵抗素、TNF-α和FFA与IRI显著相关。结论 2型糖尿病患者特别是肥胖者胰岛素抵抗更为显著,抵抗素、TNF-α和FFA均参与胰岛素抵抗,可能是影响体内胰岛素抵抗的重要相关因素。

The relationship between serum adipocytokine level and insulin resistance in type 2 diabetes mellitus

Objective To ascertain the relationship between serum level of adipocytokine in type 2 diabetes mellitus and insulin resistance(IR).Methods 30 non-obese DM subjects,30 obese DM subjects,and 30 normal subjects were selected randomly.The serum resistin,tumor necrosis factor-alpha(TNF-α) and FFA level were measured by enzyme-linked immunosorbent assay,and their fasting glucose(FPG),HbA1c,fastinginsulin,totalcholesterol(TC),triglyceride(TG) were measured at the same time.The body height,weight and blood pressure were measured,and then the BMI and WHR were calculated;the insulin resistance index were calculated by homeostasis model assessment(Homa);The results were compared between them.Results The serum resistin levels,TNF-α and FFA level in the non-obese DM subjects and obese DM subjects were much higher than that in the normal control group.The difference of the serum Resistin levels,TNF-α and FFA levels between the non-obese DM subjects and obese DM subjects were significant(P<0.05).The serum resistin level showed positive correlation with BMI,FPG,HA1C,TG and IRI.But no association with insulin,TCH,SBP,DBP and WHR;The serum TNF-α,FFA levels were positively correlated to BMI,FPG,HA1C,TG,FINS and IRI.It had no association with WHR,SBP.Multiple regression analysis showed the serum level of resistin,TNF-α and FFA positively correlated to IR.Conclusion The insulin resistance is significant in type 2 dibetes mellitus patients,especially in obese patients.Resistin,TNF-α and FFA are probably the important factors affecting the insulin resistance.