新诊断2型糖尿病患者血清骨膜蛋白及脂联素水平变化与胰岛素抵抗相关性研究  

The relation between serum periostin and adiponectin level and insulin resistance in newly diagnosed type 2 diabetic mellitus

作　　者：刘文文 潘佳秋[1] 于学静[1] 张程昌 姜慧 LIU Wen-wen;PAN Jia-qiu;YU Xue-jing(Department of Endocrinology,the First Affiliated Hospital of Jiamusi University,Heilongiiang Jiamusi 154002,China)

机构地区：[1]佳木斯大学附属第一医院,黑龙江佳木斯154002

出　　处：《微量元素与健康研究》2019年第1期11-13,19,共4页Studies of Trace Elements and Health

摘　　要：目的:探讨新诊断2型糖尿病(n T2DM)患者空腹血清骨膜蛋白与脂联素表达水平的变化及其与胰岛素抵抗(IR)的关系及意义。方法:选取n T2DM肥胖患者30例为T2DM肥胖组(BMI≥25 kg/m2),非肥胖的n T2DM患者30例作为T2DM非肥胖组(BMI <25 kg/m2),另选取糖耐量正常者(BMI <25 kg/m2) 30例为对照组。采用ELISA法检测各组受检者空腹血清骨膜蛋白及脂联素水平,应用改良的稳态模型公式分别计算出各组的胰岛素抵抗指数(HOMA-IR)、胰岛素敏感性指数(ISI)和胰岛β细胞功能指数(HOMA-β),比较各组间数值的相关性。结果:(1) T2DM肥胖组血清骨膜蛋白水平较T2DM非肥胖组升高(P=0. 001),且两组均明显高于正常对照组(P=0. 000);而正常对照组、T2DM非肥胖组、T2DM肥胖组的脂联素水平依次降低(P<0. 05)。(2) Pearson相关分析表明血清骨膜蛋白与BMI、空腹血糖(FPG)、甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白(LDL-C)、糖化血红蛋白(Hb A1C)、空腹胰岛素(FINS)及HOMA-IR呈正相关(P <0. 05),与高密度脂蛋白(HDL-C)、ISI、HOMA-β及脂联素呈负相关(P <0. 01)。(3)以骨膜蛋白作为因变量,进行多元逐步回归分析发现,TG、HOMA-IR为骨膜蛋白的独立影响因素(P <0. 05)。结论:n T2DM患者血清骨膜蛋白水平升高可能参与了肥胖、糖脂代谢功能紊乱、IR及T2DM的发生与发展,并且骨膜蛋白与脂联素之间存在相关性。Objective: To explore the levels of periostin and adiponectin as well as their relationship with insulin resistance( IR) in newly diagnosed type 2 diabetes mellitus( nT2DM). Methods: 30 obese patients newly diagnosed as T2 DM( obese group,BMI≥25 kg/m2),30 non-obese patients newly diagnosed as T2 DM( non-obese group,BMI < 25 kg/m2),30 healthy subjects with normal glucose tolerance( control group,BMI < 25 kg/m2) were enrolled in this study. Periostin and adiponectin level was measured by a commercial solidphase ELISA kit. The estimation of IR was calculated by HOMA-IR,HOMA-β and ISI,test the correlation of index between each group. Results:(1) The level of serum periostin in type 2 diabetic obese group was higher than that in type 2 diabetes non-obese group( P = 0. 001),and the two groups were significantly higher than the normal control group( P = 0. 000);but the level of adiponectin reduced in control groups,non-obese,obese( P < 0. 05).(2) Pearson correlation analysis showed that the level of serum periostin had positive correlation with BMI,FPG,TG,TC,HbA1 c,FINS and HOMA-IR( P < 0. 05),and positive correlation with HDL-C,ISI,HOMA-β and adiponectin( P < 0. 01).(3) Multiple stepwise regression showed that TG and HOMA-IR were independently associated with serum periostin level( P < 0. 05). Conclusion: The rise of serum periostin level may be involved in obesity,glycolipid disorder and the occurrence and development of IR and T2 DM,and there is a correlation between periostin and adiponectin.

关 键 词：2型糖尿病 骨膜蛋白 脂联素 胰岛素抵抗 肥胖 

分 类 号：R587.1[医药卫生—内分泌]