血清脂联素水平在磺脲类药物继发性失效的2型糖尿病患者中的变化及临床意义  

Changes and clinical significance of serum adiponectin in patients with type 2 diabetes of secondary failure to sulfonylureas

作　　者：卢芙蓉[1] 秦铀[2] 熊鹏程[1] 李静[1] 沈霖[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院中西医结合科,武汉430022 [2]华中科技大学同济医学院附属协和医院血液科,武汉430022

出　　处：《临床内科杂志》2010年第2期96-98,共3页Journal of Clinical Internal Medicine

基　　金：湖北省卫生厅资助课题,编号：鄂卫发2006（63）

摘　　要：目的观察磺脲类降糖药（SU）继发性失效2型糖尿病患者血清脂联素水平与血糖控制良好2型糖尿病患者及正常人之间的差异。方法采用ELISA法检测所有受试者血清脂联素水平，同时检测血糖和血脂，计算体重指数，进行相关性分析。结果血糖控制良好的患者脂联素明显低于正常人（P〈0．05），SU继发性失效的患者明显低于血糖控制良好的患者（P〈0．05）；两组2型糖尿病患者胰岛素抵抗水平均明显高于正常人（P均〈0．05），而两组患者比较无明显差异（P〉0．05）。SU继发性失效患者脂联素水平与空腹血糖、餐后2小时血糖、糖化血红蛋白、体重指数、空腹胰岛素、胰岛素抵抗指数、胆固醇、总甘油三酯及低密度脂蛋白胆固醇呈明显负相关（P均〈0．05），与高密度脂蛋白胆固醇呈明显正相关（P〈0．05）。结论脂联素水平下降和胰岛素抵抗相互影响，可能参与了2型糖尿病SU继发性失效的发生发展。Objective To investigate the differences of serum adiponectin （APN） level between patients with type 2 diabetes mellitus （T2DM） of secondary failure to sulfonylureas （ SFS）, well-controlled T2DM patients（WCP） and normal control（NC）. Methods ELISA assay was applied to measure serum APN level in all subjects. Meanwhile, blood glucose, blood fat and body mass index（BMI） were observed. Results APN level was markedly lower in WCP than in NC （P 〈 0.05） and significantly lower in T2DM patients with SFS than in WCP（P 〈 0.05）. Higher insulin resistance was observed in T2DM patients than in NC （P 〈 0.05 ）, but there was no remarkable difference between the two T2DM groups （P 〉 0.05 ）. In T2DM with SFS, APN level was negatively correlated to FPG,2hPG, HbAlc, BMI, FINS, HOMA-IR, TC, TG and LDL-C （ P 〈 0.05 ）, and positively correlated to HDL-C （ P 〈 0.05 ）. Conclusion The interaction of serum APN decline and insulin resistance in T2DM patients might play an important role in the development of SFS.

关 键 词：磺脲类药物 失效 继发性 2型糖尿病 脂联素 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]