2型糖尿病合并酮症患者血浆FGF-21水平改变  

The changes of plasma FGF-21 levels in the patients with type 2 diabetes-complicated ketosis

作　　者：何宁[1] 李伶[2] 杨刚毅[1] 陈文雯[1] 李生兵[1] 李钶[1] 

机构地区：[1]重庆医科大学附属第二医院内分泌科,400010 [2]重庆医科大学检验系临床生化教研室和教育部实验诊断重点实验室

出　　处：《中国糖尿病杂志》2009年第4期284-286,292,共4页Chinese Journal of Diabetes

基　　金：国家自然科学基金项目(30771037);国家教委春晖计划资助项目(2003-56)

摘　　要：目的探讨初诊T2DM及其酮症(T2DK)患者血浆FGF-21水平变化与BMI、WHR、血糖、血浆胰岛素水平等的关系。方法放免法测定68例T2DM、41例T2DK患者及52例正常人(NC组)血浆FGF-21水平,分析血浆FGF-21水平与BMI、WHR、HOMA-IR、HOMA-IS、血脂、血糖、血浆胰岛素和FFA水平等的关系。结果血浆FGF-21水平T2DM组明显高于NC组,T2DK组又明显高于T2DM组。空腹血浆FGF-21水平分别与SBP、DBP、FPG、2hPG、HbA_1c、HDL-C和FFA呈明显正相关,与Fins、2hIns和HOMA-IS呈明显负相关。DBP、wHR、2hIns、2hPG和FFA是影响血浆FGF-21水平的独立相关因素。控制年龄、性别、血压等后,血浆FGF-21水平与T2DM及T2DK发病均呈显著相关,其似然比呈上升趋势。结论血浆FGF-21水平的改变与糖脂代谢紊乱和胰岛素分泌有关,并可能参与了T2DM及T2DK的发生和发展。Objective To investigate the changes of plasma fibroblast growth factor-1 （FGF-21） levels and the relationship of plasma FGF-21 levels with body mass index （BMI）, waist hip ratio （WHR）, blood glucose, plasma insulin levels and other factors in patients with type 2 diabetes mellitus （T2DM） and its ketosis （T2DK）. Methods Plasma FGF-21 levels were assayed by RIA in 68 patients with newly diagnosed T2DM, 41 subjects with T2DK and 52 control subjects. The relationship of plasma FGF-21 level with BMI, HOMA-IR, HOMA-IS, blood lipids, plasma glucose, insulin and free fatty acids（FFA） were also analyzed. Results Plasma FGF-21 levels were significantly increased in T2DM versus control （2. 82±0.14 vs 2. 28±0.16 ng/ml,P〈0.05）, and higher in T2DK than in T2DM （4. 05±0.18 vs 2.82 ±0.14 ng /ml,P〈0.01）. Plasma FGF-21 levels correlated positively with SBP, DBP, FPG, 2h OGTT glucose （2hPBG）, HbA1c, HDL-C and FFA （r=0.17, r=0.18, r=0.52, r=0. 57, r=0.43, r= 0.18, r=0.18, P〈0.01 and P〈0.05）, and negatively with fasting plasma insulin （Fins）, 2h OGTT insulin（2hlns） and HOMA-IS （r=-0.38, r=-0.54, r=-0.54, all P〈0.01）. Multiple regression analysis showed that DBP, WHR, 2hlns, 2hPBG and FFA were independently related factor influencing plasma FGF-21 levels. Multivariate logistic regression analysis revealed FGF-21 as an independent association factor for T2DM and T2DK even after full adjustment of known biomarkers. Conclusions Plasma FGF-21 level is associated with metabolism disorder and insulin secretion, and it may contribute, in part, to the pathogenesis of T2DM and T2DK.

关 键 词：FGF-21 糖尿病 2型 糖尿病酮症 

分 类 号：R587.1[医药卫生—内分泌]