血清单核细胞趋化蛋白1浓度与葡萄糖钳夹试验中胰岛素敏感性的关系  

Serum monocyte chemoattractant protein-1 concentration in relation to tissue insulin sensitivity in glucose clamp study

作　　者：李佳[1] 姜鲜[2] 陈秋[1] 

机构地区：[1]泸州医学院附属医院内分泌科,四川泸州646000 [2]泸州医学院附属医院麻醉科,四川泸州646000

出　　处：《临床荟萃》2009年第6期486-489,共4页Clinical Focus

摘　　要：目的评价单核细胞趋化蛋白1(MCP-1)与正常糖耐量者、2型糖尿病患者葡萄糖钳夹试验中胰岛素敏感性的关系。方法分别对15例正常糖耐量者和20例2型糖尿病患者进行高胰岛素-正葡萄糖钳夹试验,以钳夹稳态期胰岛素介导的葡萄糖利用率(Rd)来判定周围组织胰岛素敏感性。同时用酶联免疫吸附测定(ELISA)法测定血清MCP-1水平,并测定其他临床指标,分析各指标之间的相关性及与胰岛素敏感性的关系。结果与正常糖耐量者相比,2型糖尿病患者外周血MCP-1水平明显升高(P<0.01),Rd值明显降低(P<0.01),其中MCP-1(65.64±17.67)ng/Lvs(144.39±61.63)ng/L,Rd(10.05±2.24)mg·kg-1.min-1vs(6.33±2.41)mg·kg-1.min-1,两者呈负相关(P<0.001)。Rd值、MCP-1均与体质量指数、腰围呈中度相关。偏相关分析和多元逐步回归分析显示,MCP-1是胰岛素敏感性的独立影响因素。结论外周血MCP-1与胰岛素抵抗、2型糖尿病关系密切。既独立于体质量、腰围、血脂等因素影响胰岛素抵抗的发生,又与之紧密相关,促进胰岛素抵抗的进展。Objective To evaluate serum monocyte chemoattractant protein-1 （MCP-1） in relation to tissue insulin sensitivity in glucose clamp study. Methods Hyperinsulinemie euglycemic clamp was performed in 15 subjects of normal glucose tolerance and 20 cases of type 2 diabetes. Before the clamp study, serum MCP-1 was determined by enzyme-linked immunosorbent assay and other clinical parameters were determined for their relationship analysis. Results In type 2 diabetic patients,serum MCP-1 was remarkedly higher than that in normal glucose tolerance and the rate of insulin-mediated glucose disposal （Rd） was lower （ P 〈 0.01）, which was significantly correlated negatively （P 〈 0. 001） ,including MCP-1 （65.64± 17.67） ng/L vs （144.39 ± 61.63） ng/L, Rd （10.05 ± 2.24） mg · kg^-1 · min^-1 vs （6.33 ± 2.41） mg · kg^-1 · min^- 1. MCP-1 and Rd were correlated with body mass index（BMI）, waist circumference. Partical correlated analysis and stepwise regression analysis indicated MCP-1 was the independent contributing factor for Rd. Conclusion Serum MCP-1 level is associated with insulin resistance and type 2 diabetes. It is the independent contributing factor for insulin sensitivity and it contributes to the development of insulin resistance with BMI,waist circumference and blood lipid.

关 键 词：糖尿病 2型 趋化因子CCL2 葡萄糖钳制技术 胰岛素抵抗 酶联免疫吸附测定 

分 类 号：R587.1[医药卫生—内分泌]