血浆脂肪甘油三酯脂酶水平与肥胖、胰岛素抵抗相关因素的关系研究  

Correlation between plasma adipose triglyceride lipase levels and obesity and insulin resistance relevant factors

作　　者：刘颖[1,2] 李伶[3] 杨刚毅[1] 王毅[4] 陈文雯[1] 董靖[1] 李仁哲[3] 杨艳[3] 

机构地区：[1]重庆医科大学附属第二医院内分泌科,重庆400010 [2]四川省成都市郫县人民医院 [3]重庆医科大学检验系临床生化教研室,重庆400010 [4]重庆市第九人民医院内分泌科,重庆400010

出　　处：《解放军医学杂志》2010年第7期871-874,共4页Medical Journal of Chinese People's Liberation Army

基　　金：国家自然科学基金(30771037;30370671)

摘　　要：目的探讨初诊2型糖尿病(T2DM)伴肥胖患者血浆脂肪甘油三酯脂酶(ATGL)水平变化及其与体重指数(BMI)、腰臀比(WHR)、血脂、血糖、血浆胰岛素水平等的关系。方法纳入T2DM患者及健康体检者共161例,分为4组:初诊T2DM患者(T2DM)组、初诊T2DM伴肥胖患者(T2DM-ob)组、正常糖耐量伴肥胖者(NGT-ob)组和正常对照(NGT)组。再根据胰岛素抵抗指数(HOMA-IR)中位数将上述161例患者分为胰岛素抵抗(IR)组及胰岛素敏感(IS)组。采用酶联免疫法(ELISA)测定上述受试者血浆ATGL水平,并分析其与BMI、WHR、血脂、血糖、血浆胰岛素、HOMA-IR等的关系。结果 4组间血浆ATGL水平差异均无统计学意义,但4组中T2DM-ob组、T2DM组ATGL浓度分别与NGT-ob组、NGT组比较有降低的趋势。IR组ATGL水平(61.7±21.6μg/L)明显低于IS组(75.3±22.9μg/L,P<0.01)。血浆ATGL水平与高密度脂蛋白胆固醇(HDL-C)呈明显正相关(r=0.229,P<0.01),而与空腹胰岛素(FINS)、HOMA-IR呈明显负相关(r=-0.199,P<0.05;r=-0.234,P<0.01)。多元回归分析结果表明,HDL-C、BMI、体内脂肪百分比(FAT%)均为影响血浆ATGL水平的独立相关因素。结论血浆ATGL水平的改变与肥胖相关因素和IR等有关,并可能参与了肥胖、IR和T2DM的发生和发展。Objective To investigate the changes in plasma adipose triglyceride lipase （ATGL） levels and the relationship between plasma ATGL levels and body mass index （BMI）,waist hip ratio （WHR）,blood lipids,blood glucose,plasma insulin levels as well as other factors in newly diagnosed type 2 diabetic patients （T2DM） with obesity.Methods From January to June in 2008,a total of 161 T2DM patients and healthy subjects from Second Affiliated Hospital of Chongqing Medical University,according to diagnostic criteria of T2DM and obesity of WHO,were divided into four groups：newly diagnosed T2DM （T2DM） group,newly diagnosed T2DM with obesity （T2DM-ob） group,normal glucose tolerance with obesity （NGT-ob） group and normal controls （NGT） group.The 161 subjects above were then divided again,according to the median of insulin resistance index （HOMA-IR）,into insulin resistance group （IR） and insulin-sensitive group （IS）.Plasma ATGL levels were determined by enzyme linked immunosorbent assay （ELISA）.The relationship between plasma ATGL levels and BMI,WHR,blood lipids,plasma glucose,plasma insulin,HOMA-IR were also analyzed.Results There was no significant difference in plasma ATGL levels among the 4 groups,but it was showed that plasma ATGL levels in T2DM-ob and NGT-ob group were decreased compared respectively with T2DM and NGT group.Plasma ATGL levels in IR group （61.7±21.6μg/L） were significantly decreased compared with that in IS group （75.3±22.9μg/L,P〈0.01）.Plasma ATGL levels correlated positively with high-density lipoprotein cholesterol （HDL-C,r=0.229,P〈0.01）,and negatively with fasting insulin （FINS）,HOMA-IR （r=-0.199,P〈0.05;r=-0.234,P〈0.01）.Conclusion Change in ATGL level is associated with obesity related factors and insulin resistance,and it may contribute to the pathogenesis of obesity,insulin resistance and T2DM.

关 键 词：脂肪甘油三酯脂酶 糖尿病 2型 肥胖症 胰岛素抗药性 

分 类 号：R581.1[医药卫生—内分泌]