血清脂联素水平与2型糖尿病心血管病变的相关性  

Correlation between serum level of adiponectin and type 2 diabetic cardiovascular disease

作　　者：刘红[1] 洪兵[2] 夏宁[3] 邓宏明[3] 黄瑞衡[4] 杨曦[1] 吴媛[1] 

机构地区：[1]广西医科大学第一附属医院老年内分泌科,广西壮族自治区南宁市530021 [2]广西医科大学第一附属医院内分泌学 [3]广西医科大学第一附属医院糖尿病代谢中心,广西壮族自治区南宁市530021 [4]广西医科大学第一附属医院核医学科放免室,广西壮族自治区南宁市530021

出　　处：《中国临床康复》2004年第36期8214-8216,共3页Chinese Journal of Clinical Rehabilitation

基　　金：中央保健局专项基金项目(桂B031)~~

摘　　要：目的:探讨脂联素变化与2型糖尿病心血管病变的关系,以及脂质干预对血清脂联素水平的影响。方法:放射免疫测定法(RIA)测定2型糖尿病无心血管病变(无心血管病变组,25例),伴心血管病变(伴心血管病变组,36例)及正常对照组(30例)的空腹血清脂联素等指标。结果:①无心血管病变组、伴心血管病变组血清脂联素均低于正常对照组依次为(6.89±2.52),(5.24±1.49),(12.30±4.71)mg/L,t=3.283,P<0.01,且有心血管病变组组显著低于无心血管病变组(P<0.05);血清脂联素水平还受性别和肥胖等因素影响。②控制性别、年龄和体质量指数等混杂因素后偏相关分析显示:脂联素分别与腰围、腰臀比、血压、空腹血糖、稳态模型法评估的胰岛素抵抗、三酰甘油以及血浆Ⅰ型纤溶酶原激活物抑制因子呈负相关,与胰岛素敏感指数呈正相关。③Logistic回归分析显示:低脂联素血症是糖尿病心血管病变的独立危险因子。④脂质干预12周后,血脂控制满意组治疗后脂联素犤(14.81±4.44)mg/L犦,高于血脂控制较差组犤(10.68±4.57)mg/L犦(t=3.586,P<0.01)。结论:2型糖尿病尤其伴心血管病变时存在低脂联素血症;低脂联素血症是预测糖尿病心血管病变的危险因子之一,而脂质代谢异常的改善可以使脂联素水平明显升高。AIM: To investigate the association of serum adiponectin levels with type 2 diabetic cardiovascular diseases and the effect of lipid intervention on the serum levels of adiponectin.<METHODS: The fasting serum levels of adiponectin were measured with radioimmunoassay in 25 type 2 diabetics without cardiovascular disease (non cardiovascular disease group), 36 type 2 diabetics with cardiovascular disease (cardiovascular disease group) and 30 normal controls.<RESULTS: ① The serum adiponectin levels in the non cardiovascular disease group [(6.89± 2.52) mg/L] and cardiovascular disease group [(5.24± 1.49) mg/L] were significantly lowe than that in the normal control group [(12.30± 4.71) mg/L] (t=3.283, P< 0.01), and it was significantly lower in the cardiovascular disease group than in the non cardiovascular disease group (P< 0.05). The serum adiponectin level was influenced by gender and obesity. ② The partial correlation analysis after adjusting confounding factors, such as of gender, age and body mass index (BMI) showed that the serum adiponectin levels were negatively correlated with waist circumference,waist to hip ratio(WHR), blood pressure, fasting glucose, homeostasis model assessment of insulin resistance(HOMA IR), triacylglcerol (TG) and plasminogen activator I inhibitor type 1 (PAI 1), and positively correlated with insulin sensitivity index (ISI). ③ The results of Logistic regression analysis indicated that hypoadiponectinemia and hypertriglyceridemia were independent risk factors for diabetic cardiovascular disease.④ Twelve weeks after lipid intervention, the serum levels of adiponectin in the satisfactory group [(14.81± 4.44) mg/L] was significantly higher than that in the unsatisfactory group [(10.68± 4.57) mg/L] (P< 0.01). <CONCLUSION: Hypoadiponectinemia exists in type 2 diabetic patients, and especially in those accompanied with cardiovascular disease, which might be one of the risk factors and a predictor of diabetic cardiovascular diseases. The amelioration of abnormal

关 键 词：糖尿病 非胰岛素依赖 心血管疾病/病理学 脂类/血清 

分 类 号：R587.1[医药卫生—内分泌]