初发2型糖尿病合并高血压患者血清内脂素、网膜素和TNF-α水平的变化  

The Changes of Serum Visfatin, Omentin and TNF-α in Newly Diagnosed Type 2 Diabetic Patients with Hypertension

作　　者：熊海亮[1] 田凤石[2] 雒瑢[3] 赵紫琴[1] 郑喜兰[2] 

机构地区：[1]天津医科大学,300070 [2]天津市安康医院 [3]天津市公安医院

出　　处：《天津医药》2013年第5期408-411,共4页Tianjin Medical Journal

基　　金：天津市科技计划资助项目(项目编号:07JCYBJC11000)

摘　　要：目的探讨初发2型糖尿病(T2DM)合并高血压患者血清内脂素、网膜素和肿瘤坏死因子(TNF)-α水平的变化及意义。方法初次诊断为T2DM的患者106例,分为T2DM组54例和T2DM合并高血压组(DM+H组)52例。所有受试者测定血压、身高、体质量、血脂、尿酸,并行口服葡萄糖耐量试验与胰岛素激发试验,同时取血测定空腹与服糖120min血糖、胰岛素、内脂素、网膜素和TNF-α水平。计算体质指数(BMI)和稳态模型胰岛素抵抗指数(HOMA-IR)。结果 (1)与T2DM组相比,DM+H组空腹及服糖120min血清内脂素和TNF-α水平明显升高,网膜素水平明显降低(P<0.05)。(2)内脂素和TNF-α均与收缩压、腰围、空腹胰岛素和HOMA-IR呈正相关,而网膜素与舒张压、腰围、空腹胰岛素和HOMA-IR呈负相关。(3)多元线性回归分析显示,空腹胰岛素水平是空腹与高糖刺激下内脂素的影响因素,而收缩压则主要影响空腹内脂素水平;空腹网膜素主要受HOMA-IR和舒张压影响,而腰围、HOMA-IR、血尿酸是高糖刺激下血清网膜素的影响因素;空腹与120minTNF-α的影响因素分别为BMI和空腹胰岛素。结论初发T2DM合并高血压患者血清内脂素、网膜素和TNF-α水平明显改变,其可能通过多种途径参与了糖尿病并发高血压的病理过程。Objective To investigate the changes and significance of serum visfatin, omentin and tumor necrosis fac- tor （TNF）-α in newly diagnosed type 2 diabetic patients （T2DM） with hypertension. Methods One hundred and six patients with newly diagnosed type 2 diabetes mellitus were divided into two groups, 54 T2DM patients without hypertension （T2DM group） and 52 T2DM patients with hypertension （DM＋H group）. The values of blood pressure, height, body mass, blood lipids and uric acid were detected in two groups, and oral glucose tolerance test and insulin challenge test were performed as well. Blood samples were collected to determine the fasting blood glucose and blood glucose concentration 120 min after glucose administration, insulin, visfatin, omentin and TNF-α. The body mass index （BMI） and homeostasis model assessment insulin resistance index （HOMA-IR） were also measured. Results （1） The levels of fasting blood glucose and serum visfatin and TNF-α 120 rain after glucose administration were significantly increased in DM＋H group than those of T2DM group, but the level of omentin was significantly decreased in DM＋H group （P 〈 0.05）. （2） The levels of visfatin and TNF-α were positively correlated with systolic blood pressure, waist circumference, fasting insulin and HOMA-IR, but the level of omentin was nega- tively correlated with diastolic blood pressure, waist circumference, fasting insulin and HOMA-IR. （3） The multivariate linear regression demonstrated that the level of fasting insulin was influencing factors of fasting and glucose-stimulated visfatin, but systolic blood pressure mainly affected fasting visfatin. The level of fasting omentin was mainly affected by HOMA-IR and di- astolic blood pressure, but waist circumference, HOMA-IR and serum uric acid were variables of glucose-stimulated omen- tin. Values of BMI and fasting insulin were influencing factors of fasting and TNF-α 120 rain after glucose administration re- spectively. Conclusion The levels of seru

关 键 词：糖尿病 2型 高血压 烟酰胺磷酸核糖基转移酶 肿瘤坏死因子α 胰岛素 尿酸 内脂素 网膜素 

分 类 号：R575[医药卫生—消化系统]