2型糖尿病患者血清内脂素、脂联素和瘦素水平的变化  

Changes of Serum Visfatin,Adiponectin and Leptin Levels in Patients with Type 2 Diabetes Mellitus

作　　者：邵挥戈[1] 黄干[2] 

机构地区：[1]湖南省长沙市中心医院内分泌科,湖南长沙410004 [2]中南大学湘雅二医院内分泌科

出　　处：《实用预防医学》2010年第2期220-222,共3页Practical Preventive Medicine

基　　金：国家自然科学基金中港合作课题(30831160518)

摘　　要：目的研究2型糖尿病(T2DM)患者血清中内脂素、脂联素和瘦素水平,为阐明T2DM的发病机制提供基础。方法将220例新诊T2DM患者和214例年龄、性别与体重指数(BMI)相匹配的健康对照组,按BMI≥25kg/m2或<25kg/m2分为肥胖亚组和非肥胖亚组,采用酶联免疫吸附法(ELISA)和放射免疫法(RIA)检测其血清内脂素、脂联素和瘦素水平,并同时采用生化和化学发光法检测空腹血糖(FPG)、甘油三酯(TG)、胆固醇(Chol)以及空腹胰岛素(FINS)等。结果1.T2DM组血清内脂素、FPG、FINS、胰岛素抵抗指数(HOMA-IR)、TG、Chol水平均高于健康对照组(P<0.05～0.001),而脂联素水平低于健康对照组(P<0.001),瘦素在两组人群中差异无统计学意义(P>0.05);2.无论是T2DM组还是健康对照组中,其肥胖亚组中的内脂素、瘦素、FINS、HOMA-IR、TG、Chol水平均高于非肥胖亚组(P<0.05～0.001),而脂联素低于非肥胖亚组(P<0.01～0.001);3.消除BMI因素影响的偏相关分析显示,T2DM患者血清内脂素水平仅与FPG、FINS、HOMA-IR呈正相关(r=0.267～0.443,P<0.05～0.01),与脂联素呈负相关(r=-0.312,P<0.05)。结论内脂素和脂联素参与了肥胖、胰岛素抵抗以及T2DM发生过程,而瘦素可能仅与肥胖状况有关,未能以独立因子作用直接参与T2DM的发生。Objective To examine the serum levels of visfatin,adiponectin and leptin in patients with type 2 diabetes mellitus （T2DM）,and to provide a basis for illustrating the pathogenesis of T2DM.Methods Two hundred and twenty patients with newly diagnosed T2DM and 214 healthy subjects matched in the age,sex,body mass index （BMI） were included in the study.They were divided into 4 subgroups according to their BMI：obese T2DM subgroup （n=135）,non-obese T2DM subgroup （n=85）,obese healthy subject subgroup （n=114） and non-obese healthy subject subgroup （n=100）.Serum visfatin,adiponectin,and leptin were measured by enzyme-linked immunosorbent assay （ELISA） or radioimmunoassay （RIA）;fasting plasma glucose （FPG）,triglyceride （TG）,cholesterol （Chol）,and fasting insulin （FINS） were simultaneously measured by automatic chemistry analyzer or chemiluminescent immunoassay.Results Serum levels of visfatin,FGP,FINS,homeostatic model assessment for insulin resistance （HOMA-IR）,TG,and Chol in T2DM group were significantly higher than those in healthy control group （P0.05～0.001）,but serum level of adiponectin in T2DM group was significantly decreased as compared with healthy control group （P0.001）.No statistically significant difference was found in leptin level between T2DM group and healthy control group （P0.05）.Among T2DM group or healthy control group,serum levels of visfatin,leptin,FINS,HOMA-IR,TG,and Chol in the obese subgroup were significantly higher than those in the non-obese subgroup （P0.05～0.001）,while serum level of adiponectin was lower in the obese subgroup when compared with non-obese subgroup （P0.01～0.001）.Serum level of visfatin was positively correlated with FPG,FINS,HOMA-IR （r=0.267～0.443,P0.05～0.01）,and negatively correlated with adiponectin（r=-0.312,P0.05）in T2DM group after the influence of BMI was corrected in the covariance analysis.Conclusions The visfatin and adiponectin,instead of leptin,are involved in the process of obes

关 键 词：2型糖尿病 内脂素 脂联素 瘦素 

分 类 号：R587.1[医药卫生—内分泌]