肥胖及2型糖尿病患者血清apelin水平及其相关因素分析  

Analysis of serum apelin level and related factors in obese and type 2 diabetic patients

作　　者：魏丽[1] 贾伟平 吴海娅[1] 陆俊茜[1] 包玉倩[1] 陆惠娟[1] 潘晓平[1] 项坤三[1] 

机构地区：[1]上海市糖尿病临床医学中心上海市糖尿病研究所,上海交通大学第六人民医院内分泌代谢科,200233

出　　处：《中华内分泌代谢杂志》2007年第2期130-133,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：上海市浦江计划项目(05PJ14083)

摘　　要：目的测定肥胖及新诊断2型糖尿病患者血清apelin水平,探讨apelin与体脂、糖、脂代谢、胰岛素抵抗等的相关性。方法62例2型糖尿病患者和72例正常糖调节(NGR)者按体重指数(BMI)≥25 kg/m^2或<25 kg/m^2又各自分为超重/肥胖与正常体重亚组,采用放射免疫分析法检测空腹血清apelin水平,同时检测空腹血糖(FPG)、HbA_(1C)、血脂各项指标及空腹胰岛素(FINS)水平,计算BMI和腰臀比,并以稳态模型计算胰岛素抵抗指数(HOMA-IR)。结果校正年龄及性别后,2型糖尿病组血清apelin水平高于NGR组[(317.9±99.6 vs 279.0±66.8)ng/L,P<0.01],2型糖尿病组和NGR组中的超重/肥胖者均高于非肥胖者[(354.0±114.4 vs 274.1±53.0)ng/L,(299.2±74.5 vs 252.8±48.9)ng/L,均P<0.05],且2型糖尿病超重/肥胖组明显高于NGR肥胖组(P<0.01);偏相关分析显示,空腹血清apelin与BMI、ln (HOMA-IR)、FPG、总胆固醇(TC)呈正相关(r=0.353,r=0.355,r=0.224,r=0.241,均P<0.01),与腰围、收缩压呈正相关(r=0.263,r=0.183,P<0.05)。多元逐步回归分析发现,BMI、ln(HOMA-IR)和TC是血清apelin的独立相关因素。结论血清apelin水平在肥胖和初发的2型糖尿病人群中升高,且与BMI、HOMA-IR及脂代谢相关,推测apelin可能参与构成胰岛素抵抗综合征的病理生理基础。Objective To assay serum apelin level in obesity and newly-diagnosed type 2 diabetes mellitus （DM） patients and investigate the relationship between serum apelin level and body fat parameter, glucose and lipid metabolism and insulin resistance index, etc. Methods Sixty-two patients with type 2 DM and 72 subjects with normal glucose regulation （NGR） were selected and each group was divided into obese and non-obese subgroups according to body mass index （BMI） ≥25 kg/m^2 or 〈25 kg/m^2. The level of fasting serum apelin was measured by radioimmunoassay. Meanwhile, fasting plasma glucose （FPG） , HbA1C, lipid profile and fasting insulin level were also measured, BMI and waist-to-hip ratio were evaluated and insulin sensitivity was assessed by HOMA-IR. Results After age and sex adjustment, the serum apelin level in type 2 DM was significantly higher than that of NGR [ （ 317.9 ± 99.6 vs 279.0 ± 66.8 ） ng/L, P 〈 0. 01 ]. The apelin concentration of obese subjects are increased in both NGR and type 2 DM groups [ （ 354.0 ± 114.4 vs 274.1 ± 53. 0） ng/L, （ 299.2 ± 74.5 vs 252.8 ± 48.9）ng/L, both P 〈 0. 05 ]. The serum apelin level in type 2 DM obese group was significantly higher than that of NGR obese group （ P 〈 0. 01 ）. Correlation analysis showed that the serum apelin is positively correlated to BMI （r=0.353）, In （HOMA-IR） （r=0.355）, FPG （r=0.224）, total cholesterol （TC, r= 0. 241 ）, waist circumference （ r = 0. 263 ） and systolic blood pressure （ r = 0. 183） （ P 〈 0. 05 or P 〈 0. 01 ）. In a multiple step-wise regression analysis, BMI, In （HOMA-IR） and TC are independent factors related to apelin. Conclusion Serum apelin levels in obese and newly-diagnosed type 2 diabetic subjects are increased. Apelin is correlated with BMI, HOMA-IR and lipid level. Elevated serum apelin may contribute to the pathophysiology of insulin resistance syndrome.

关 键 词：APELIN 胰岛素抵抗 肥胖症 糖尿病 2型 脂代谢 

分 类 号：R589.2[医药卫生—内分泌] R587.1[医药卫生—内科学]