新诊断2型糖尿病患者血清视黄醇结合蛋白4和游离脂肪酸水平变化及其与胰岛素敏感性的关系研究  

Changes of Serum Retinol Binding Protein 4 and Free Fatty Acids Levels among Newly Diagnosed Type 2 DiabeticPatients and the Correlations with Insulin-sensitivity

作　　者：潘佳秋[1] 王慧慧[1] 张超[1] 于学静[1] 姜飞飞[1] 

机构地区：[1]佳木斯大学附属第一医院内分泌科,黑龙江省佳木斯市154002

出　　处：《中国全科医学》2011年第21期2370-2372,共3页Chinese General Practice

基　　金：黑龙江省卫生厅课题(2009-323)

摘　　要：目的探讨新诊断2型糖尿病(T2DM)患者血清视黄醇结合蛋白4(RBP4)和游离脂肪酸(FFA)的表达水平以及二者与胰岛素敏感性的关系。方法选取新诊断T2DM患者76例(T2DM组)及健康体检者30例(对照组)。观察各组空腹血清RBP4和FFA水平,并计算胰岛素抵抗指数(HOMA-IR)、胰岛素敏感性指数(ISI)用以评价各组胰岛素敏感性。结果 (1)T2DM组患者血清RBP4和FFA水平显著高于对照组(P<0.01)。(2)单因素相关分析显示,血清RBP4与体质指数(BM I)、三酰甘油(TG)、总胆固醇(TC)、HOMA-IR、FFA呈正相关,与ISI、HOMA-β呈负相关(P<0.05)。(3)多元逐步回归分析发现,HOMA-IR、FFA作为独立危险因素影响血清RBP4水平,常数项为零。结论 T2DM患者血清RBP4、FFA水平均显著升高;RBP4水平升高与糖脂代谢有关,从而导致胰岛素抵抗,进而参与T2DM的发生、发展。RBP4与FFA在胰岛素抵抗中可能起协同作用。Objective To explore the levels of serum retinol binding protein 4（RBP4） and free fatty acids（FFA）,as well as the relationships between RBP4 level,FFA level and insulin-resistance index（ISI） in newly diagnosed type 2 diabetic patients.Methods Both Newly diagnosed type 2 diabetes patients（T2DM,n=76） and healthy subjects（NC,n=30） were enrolled grouping this study,with their serum levels of RBP4 and FFA measured.Also,insulin resistance index（HOMA-IR） and insulin sensitivity（ISI） were calculated in both groups.Results（1）Serum levels of RBP4 and FFA in the T2DM group were significantly higher than in the control group（P0.01）.（2）Single-factor correlation analysis showed that serum RBP4 was positively correlated with BMI,triglyceride（TG）,cholesterol（TC）,HOMA-IR and FFA and negatively correlated with ISI and HOMA-β（P0.05）.（3）Multielement stepwise regression analysis discoveryed that HOMA-β and FFA were independent risk factors of elevated RBP4 levels.Conclusion Serum RBP4 and FFA levels are significantly elevated among T2DM patients.The high expression level of serum RBP4 is associated with glucose and lipid metabolism which in turn leads to the development of IR and contributes to the pathogenesis of type 2 diabetes.RBP4 and FFA might be synergistic factors in emergence the insulin resistance.

关 键 词：糖尿病 2型 视黄醇结合蛋白4 脂肪酸 非酯化 胰岛素敏感性指数 

分 类 号：R587.1[医药卫生—内分泌]