2型糖尿病家系非糖尿病正常体重一级亲属脂联素水平5年随访  

Study on adiponectin levels in non-obese first-degree relatives of patients with type 2 diabetes

作　　者：王芳[1] 刘军[1] 丁和远[1] 盛励[1] 陈灶萍[1] 郭瑜琳[2] 廖晓寰[3] 

机构地区：[1]复旦大学附属上海市第五人民医院内分泌科,上海200240 [2]复旦大学附属上海市第五人民医院心血管超声室,上海200240 [3]复旦大学附属上海市第五人民医院免疫室,上海200240

出　　处：《中华内分泌代谢杂志》2010年第2期114-117,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：基金项目：上海市科学技术委员会科研计划项目（08411962500）

摘　　要：目的探讨2型糖尿病患者非糖尿病正常体重一级亲属脂联素水平变化及脂联素与胰岛素敏感性和颈动脉内膜中层厚度（IMT）之间的关系。方法入选2型糖尿病非糖尿病正常体重一级亲属53名和对照组37名，入组时检测了脂联素、血脂、血糖、血压及空腹胰岛素水平。用高频B超检测IMT及内皮依赖性血管舒张功能（EDVD）。采用稳态模式（HOMA）评价胰岛素抵抗（HOMA-IR）和评价胰岛B细胞功能（HOMA—B）。一级亲属组29名和对照组20名完成了5年随访。结果基线时一级亲属组血浆脂联素水平明显低于对照组[（10．06±5．79）对（14．43±7．91）mg／L，P〈0．05]。5年后一级亲属组脂联素水平降低24．0％（P〈0．05），对照组脂联素水平降低36．7％（P〈0．05）。一级亲属组脂联素与腰臀比（r=-0．397）、空腹血糖（r=-0．373）、IMT（r=-0．372）和HOMA—IR（r=-0．40）负相关（均P〈0．05）。校正相关因素后，多元逐步回归分析显示一级亲属组脂联素与年龄，高密度脂蛋白胆固醇（HDL-C），IMT独立相关。对照组脂联素与低密度脂蛋白胆固醇（LDL—C）和IMT独立相关。结论5年后一级亲属组和对照组脂联素水平均明显降低，脂联素降低可能与IMT增加相关。Objective To investigate the adiponectin levels in non-obese first-degree relatives （FDR）of type 2 diabetic subjects and its relation to insulin sensitivity and the intima-media thickness of the common carotid artery （IMT） during 5-year follow-up. Methods Fifty-three FDR subjects and 37 control subjects who were free of type 2 diabetes were enrolled. Plasma adiponectin, lipid profile, blood glucose, fasting insulin, and blood pressure were determined at baseline and after 5-year follow-up. IMT and endothelial-dependent vasodilation （EDVD） were measured by high-resolution B-mode ultrasound imaging. Homeostasis model assessment was used to evaluate insulin resistance （HOMA-IR）and 13-cell function （HOMA-13）. 29 FDR subjects and 20 control subjects completed the follow-up. Results Comparing with the control, plasma adiponectin levels in non-obese FDR subjects were lower at baseline [ （10.06±5.79） vs （ 14.43 ±7.91 ） mg/L,P〈 0.051. Plasma adiponectin were decreased 24.0% in nonobese FDR and 36.7% in control duning 5 year follow-up （both P〈0. 05 ）. Adiponectin levels were negatively correlated with waist-to-hip ratio （ r = -0. 397 ）, fasting blood glucose （ r = -0. 373 ）, IMT （ r = -0. 372 ）, and HOMA-IR （ r = -0.40 ） in the non-obese FDR. After adjusting other relevant risk factors, adiponectin was associated with age, high-density lipoprotein-cholesterol, and IMT in multiple regression analyses in non-obese FDR group. In the control group, a similar analysis revealed that low-density lipoprotein-cholesterol and IMT explained 25% of the variability in the adiponectin concentration. Conclusion Plasma adiponectin levels were decreased after 5 years in both non-obese FDR and control subjects. Decreased adiponectin level may be related to IMT increment.

关 键 词：糖尿病 2型 脂联素 颈动脉内膜中层厚度 

分 类 号：R587.1[医药卫生—内分泌]