2型糖尿病患者外源性给予胰升血糖素对肥胖与血浆Ghrelin的影响  

Effects of exogenous glucagon on plasma ghrelin and obesity in type 2 diabetic patients

作　　者：林少达[1] 段红艳[1] 林楚佳[1] 陈仲贤[1] 

机构地区：[1]汕头大学医学院第一附属医院内分泌科,515041

出　　处：《中国糖尿病杂志》2011年第4期243-245,共3页Chinese Journal of Diabetes

基　　金：广东省科技技术项目(2005830701006)

摘　　要：目的探讨肥胖及非肥胖2型糖尿病(T2DM)患者胰岛素抵抗(IR)与生长激素释放肽Gh-relin分泌的关系。方法肥胖T2DM患者26例(Ob+T2DM组)及非肥胖T2DM患者32例(NOb+T2DM组),正常对照30名(NC组)行胰升血糖素-C-P释放试验,同步取血测定血浆Ghrelin和C-P。结果 (1)Ob+T2DM组空腹Ghrelin水平低于NC组和NOb+T2DM组(P<0.05或P<0.01);Ob+T2DM组FC-P及胰岛素抵抗指数(HOMA2-IR)高于NC组和NOb+T2DM组(P<0.01或P<0.05)。静脉推注胰升血糖素后,NC组Ghrelin水平显著下降(P<0.01),肥胖及非肥胖T2DM组Ghrelin水平无显著性改变。(2)Pearson相关分析显示空腹血浆Ghrelin水平分别与WC、BMI、体脂百分比、体脂重量呈负相关;多元回归分析显示腰围(WC)是Ghrelin水平的负性预测因子(回归方程Y=4.814 0.0265X)。(3)Ob+T2DM组中,空腹血浆Ghrelin水平分别与WC、BMI、体脂百分比、体脂重量、HOMA2-IR呈负相关。结论外源性给予胰升血糖素对T2DM患者Ghrelin抑制效应减弱;肥胖T2DM患者血浆Ghre-lin水平较非肥胖患者明显降低,且与WC、BMI、体脂百分比、体脂重量、HOMA2-IR负相关;中心性肥胖T2DM患者血浆Ghrelin水平下降与IR有关。Objective To study effects of exogenous glucagon on plasma ghrelin and obesity in type 2 diabetic patients. Methods The study subjects included the obese type 2 diabetics （Ob＋T2DM, n= 26）, non-obese type 2 diabetics （NOb＋T2DM, n=32） and normal control （NC, n=30）. Plasma ghrelin and C-peptide were measured during glucagon stimulation test. Results The percent ghrelin inhibition induced by exogenous glucagon was lower in non obese and obese T2DM （-0. 1% and -4.1%, respectively with inter-subgroup difference at P〈0. 05） than in normal control （- 13. 2 % ）（all P〈0. 01）. The plasma ghrelin was negatively correlated with waist circumference, BMI and body fat mass （r value of -0. 301 and P〈0. 01 ; r=-0. 25 and P〈0. 05; r= -0. 26 and P〉0. 05, respectively） in normal control group, negatively correlated with WC, BMI, BFM and HOMA-IR in obese type 2 diabetes group （r= 0. 31and P〈 0. 01; r=--0. 26 and P%0. 05; r=--0. 30 and P〈0. 05; r=0. 30 and P〈0. 05 respectively）. Fasting ghrelin was independently correlated with waist circumference. Conclusions Fasting ghrelin level in obese T2DM group is lower than in non-obese T2DM group,and is correlated with waistline,body mass index, body fat percentage, body fat weight, HOMA2-IR. The decreasing of fasting ghrelin in central obese diabetic patients may be related with insulin resistance.

关 键 词：糖尿病 2型 GHRELIN 胰升血糖素 肥胖 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]