2型糖尿病患者血清脂联素、瘦素和游离脂肪酸与代谢及炎症因子的相关性  

Circulating adiponectin,leptin and free fatty acids levels in relation to metabolism and inflammatory markers in type 2 diabetic subjects

作　　者：王辉[1] 肖新华[1] 鄢盛凯[2] 孙琦[1] 王姮[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院内分泌科,北京100730 [2]中国医学科学院中国协和医科大学北京协和医院检验科,北京100730

出　　处：《基础医学与临床》2006年第5期503-507,共5页Basic and Clinical Medicine

摘　　要：目的探讨2型糖尿病时脂肪细胞因子--脂联素、瘦素、游离脂肪酸（FFA）与肥胖、糖、脂代谢及炎症因子的关系.方法选择77例体重正常、超重或肥胖的2型糖尿病患者及26例正常对照,测定空腹血清脂联素、瘦素、FFA、超敏C反应蛋白（hs-CRP）及代谢参数.结果 2型糖尿病患者下列指标显著高于对照组：血清瘦素（μg/L）（4.5±3.9比较4.1±2.1）、hs-CRP（mg/L）（0.69±1.07比较0.33±0.47）、FFA（μmol/L）（566±227比较391±129）及甘油三酯（TG）（mmol/L）（1.61±1.02比较1.01±0.40）;而下列指标显著低于对照组：血清脂联素（mg/L）（5.5±3.4比较9.1±4.1）、高密度脂蛋白胆固醇（HDL-C）（mmol/L）（1.22±0.27比较1.48±0.26）、载脂蛋白AI（mmol/L）（1.35±0.19比较1.49±0.18）及载脂蛋白AⅡ（mmol/L）（0.29±0.07比较0.34±0.06）（P＜0.05）.血清脂联素与HDL-C、载脂蛋白AⅠ、载脂蛋白AⅡ、空腹血糖、空腹胰岛素、胰岛素抵抗指数（HOMAIR）、TG及hs-CRP均显著相关（P＜0.01～P＜0.001）.血清瘦素与空腹胰岛素、HOMA-IR及hs-CRP显著相关（P＜0.01～P＜0.001）.血清FFA与体重指数、腰围、空腹血糖及HOMA-IR均显著相关（P＜0.05～P＜0.001）.脂联素和瘦素是超敏C反应蛋白的决定变量,分别可解释其变异的36%和12%.结论脂肪细胞因子在调节糖、脂代谢及炎症方面有重要意义,可能是肥胖与代谢及心血管疾病之间的联系分子.Objective To characterize the association of adiponectin, leptin and free fatty acids（FFA） with adiposity, insulin resistance, lipid profiles and inflammatory markers in type 2 diabetes. Methods We measured fasting serum adiponectin, leptin, FFA, high-sensitive C reactive protein（hs-CRP） levels and metabolic parameters in 77 cases of type 2 diabetic patients with or without obesity and 26 healthy subjects. Results Following parameters were significantly higher in type 2 diabetic patients than in healthy subjects： fasting serum leptin （μg/L） （4. 5 ± 3.9 vs 4. 1 ± 2. 1 ）, hs-CRP （mg/L） （0. 69 ± 1.07 vs 0. 33 ± 0. 47 ）, FFA （μmol/L） （ 566 ± 227 vs 391 ± 129 ） and triglyceride （mmol/L） （1.61 ± 1.02 vs 1.01 ±0. 40） ; however, following parameters were significantly lower in type 2 diabetic patients than in healthy subjects： serum adiponectin （mg/L）（5.5 ±3.4 vs 9. 1 ±4. 1 ）, highdensity lipoprotein cholesterol （HDL-C） （mmol/L） （1.22 ± 0. 27 vs 1.48 ± 0. 26 ）, apolipoprotein AI （mmol/L） （ 1.35 ±0. 19 vs 1.49 ±0. 18） and apolipoprotein All （mmol/L） （0. 29 ±0. 07 vs 0. 34 ±0. 06） concentrations （ P 〈 0. 05）. Serum adiponectin levels were significantly associated with HDL-C, apolipoprotein AI, apolipoprotein All, fasting glucose and insulin levels, insulin resistance index （HOMA-IR）, triglyceride and hs-CRP （P 〈0. 01- P 〈0. 001 ）. Serum leptin concentrations were significantly associated with serum insulin, HOMA-IR and hs- CRP （P 〈0.01 - P 〈0. 001 ）. FFA was significantly associated with body mass index, waist circumference, fasting blood glucose and HOMA-IR （ P 〈 0. 05 -P 〈 0. 001 ）. Adiponectin and leptin were predictors of hs-CRP, contributing to 36% and 12% of hs-CRP variance, respectively. Conclusions Adipocytokines play an important role in hyperglycemia, dyslipidemia and inflammation and may link obesity with metabolic and cardiovascular diseases.

关 键 词：脂联素 瘦素 游离脂肪酸 C反应蛋白 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]