新诊断2型糖尿病患者血浆脂肪甘油三酯脂酶和游离脂肪酸与胰岛素抵抗的关系研究  

Associations of Fatty Triglyceride Lipase and Free Fatty Acids with Insulin Resistance in Newly Diagnosed Type 2 Diabetic Patients

作　　者：潘佳秋[1] 姜飞飞[1] 杨玉红[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32期3702-3704,共3页Chinese General Practice

摘　　要：目的探讨新诊断2型糖尿病(T2DM)患者血浆脂肪甘油三酯脂酶(ATGL)、游离脂肪酸(FFA)表达水平及其与胰岛素抵抗(IR)的关系。方法选取新诊断T2DM患者55例作为病例组(DM组)及健康体检者30例作为正常对照组(NC组)。检测两组受检者空腹血浆ATGL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),对ATGL、FFA及其他因素进行单因素相关性分析,然后进行多元逐步回归分析。结果 (1)DM组患者血浆ATGL水平显著低于NC组〔(23.59±3.94)μg/L与(31.20±2.05)μg/L〕,血浆FFA水平显著高于NC组〔(0.35±0.14)mmol/L与(0.23±0.10)mmol/L〕,组间差异有统计学意义(P<0.01)。(2)单因素相关性分析显示,血浆ATGL水平与高密度脂蛋白(HDL)、ISI呈正相关(P<0.05),与空腹血糖(FPG)、体质指数(BMI)、HOMA-IR、FFA呈负相关(P<0.01)。(3)多元逐步回归分析发现:HOMA-IR、ISI是ATGL水平的独立影响因素,ISI是FFA的独立影响因素(P<0.05)。结论初诊T2DM患者血浆ATGL水平较健康者显著下降,而FFA水平则显著升高;ATGL与HOMA-IR呈负相关,而FFA与HOMA-IR呈正相关。Objective To investigate the associations of fatty triglyceride lipase（ATGL） and free fatty acids（FFAs） with insulin resistance in newly diagnosed type 2 diabetes mellitus（T2DM）patients.Methods A total of 55 patients with newly diagnosed T2DM（the DM group） and 30 healthy subjects（the NC group）.ATGL and fasting plasma FFA levels were detected.insulin resistance index（HOMA-IR） and insulin sensitivity（ISI） were calculated.Univariate analysis and multiple regression analysis were performed on ATGL,FFA and other factors.Results T2DM patients showed lower plasma ATGL levels（（23.59±3.94）μg/L） than normal controls（（31.20±2.05）μg/L）;T2DM patients showed higher plasma FFA levels（（0.35±0.14）mmol/L）than the control subjects（（0.23±0.10）mmol/L）;all differences were statistically significant（P0.05）.Univariate analysis showed that plasma ATGL levels were positively correlated with high density lipoprotein（HDL） and ISI（P0.05）,while negatively correlated with fasting blood glucose,body mass index（BMI）,HOMA-IR and FFA（P0.01）.Multiple stepwise regression analysis showed that HOMA-IR and ISI were independent risk factors of ATGL levels,while ISI was among the independent risk factors of FFA levels（P0.05）.Conclusion Newly diagnosed T2DM patients showed higher levels of ATGL and lower levels of FFA compared with healthy subjects.ATGL is negatively correlated with HOMA-IR and FFA is positively correlated with HOMA-IR.

关 键 词：糖尿病 2型 脂肪酶 脂肪酸类 非酯化 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]