肥胖及2型糖尿病患者血浆CTRP3水平与胰岛素抵抗相关因素的研究  

Relationship of plasma C1q /TNF-related protein 3 with insulin resistance in patients with type 2 diabetes mellitus and obesity

作　　者：邓敏[1] 陈晨[1] 瞿华[1] 王行[1] 魏慧丽[1] 邓华聪[1] 

机构地区：[1]重庆医科大学附属第一医院内分泌科,重庆400016

出　　处：《第三军医大学学报》2014年第15期1614-1618,共5页Journal of Third Military Medical University

基　　金：国家自然科学基金(81270911)~~

摘　　要：目的测定正常人群、肥胖及2型糖尿病(type 2 diabetes mellitus,T2DM)患者血浆中补体C1q/肿瘤坏死因子相关蛋白3(C1q/TNF-related protein 3,CTRP3)水平,探讨CTRP3与胰岛素抵抗相关因素的关系。方法按是否新诊断为T2DM,分为正常糖耐量组(NGT)88例和T2DM组86例,以BMI≥25 kg/m2为分割点,将两组组内分正常体质量(NW)亚组和肥胖(OB)亚组。分析CTRP3与空腹血糖(FPG)、2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、血脂、白介素-6(IL-6)以及体质量指数(BMI)和腰臀比(WHR)、血压等指标的关系。稳态模型评估胰岛素抵抗指数(HOMA-IR),HOMA-IR=FINS×FPG/22.5。ELISA法检测CTRP3及IL-6水平。结果 1T2DM组血浆CTRP3水平显著低于NGT组[(369.59±117.56)vs(445.42±124.03)ng/mL,P<0.01],OB组CTRP3水平显著低于NW组[(352.87±106.38)vs(464.29±120.71)ng/mL,P<0.01]。2单因素相关分析显示血浆CTRP3水平与性别、年龄、血压和TC、LDL-c无相关(P>0.05),而与BMI、腰围(WC)、WHR、FPG、2hPG、HbA1c、TG、FINS、HOMA-IR及IL-6负相关(P<0.01),与HDL-c正相关(P<0.05)。3以CTRP3为因变量行多元逐步回归分析,CTRP3水平与HbA1c、TG、HOMA-IR独立相关(P<0.05)。结论新诊断的T2DM和肥胖患者血浆CTRP3水平较正常人明显降低;CTRP3与肥胖、糖脂代谢紊乱、炎症及胰岛素抵抗密切相关;HbA1c、TG、HOMA-IR为血浆CTRP3的独立影响因素,推测CTRP3可能参与了肥胖及T2DM的病理生理过程。Objective To detect the plasma level of Clq/TNF-related protein （CTRP）3 in the healthy, obesity and type 2 diabetes mellitus （T2DM） subjects, and investigate the association of plasma CTRP3 level with insulin resistance index and related factors. Methods Eighty-eight individuals with normal glucose tolerance （NGT） and eighty-six patients with newly diagnosed T2DM were enrolled in this study. Then they were divided into obese （OB） subgroup and normal weight subgroup （NW） according to their body mass index （BMI） ≥25 kg/m2 or not. The relationship of plasma CTRP3 level with fasting plasma glucose （FPG）, 2h plasma glucose （2hPG）, glycosylated hemoglobin （HbAlc）, fasting insulin （FINS）, lipids and interleukin-6 （IL-6）, BMI, waist-to-hip ratio （WHR） and blood pressure were evaluated. Homeostasis model assessment （HOMA） was used to calculate the insulin resistance index （ HOMA-IR = FINS x FPG/22.5 ）. Levels of CTRP3 and IL-6 were detected by ELISA. Results The plasma level of CTRP3 was significantly lower in T2DM group than NGT group （369.59±117.56 vs 445.42 ±124.03 ng/mL, P 〈0.01 ）, and the level was also obviously lower in OB subjects than in NW subjects （352.87 ± 106.38 vs 464.29 ± 120. 71 ng/mL, P 〈 0.01 ）. Single factor correlation analysis showed that the plasma level of CTRP3 had no correlation with gender, age, blood pressure, TC and LDL-c （ P 〉 0.05 ）, but had negative correlation with BMI, WC, WHR, FPG, 2hPG, HbAlc, TG, FINS, HOMA-IR and IL-6 （P 〈0.01）, and positive correlation with HDL-c （P 〈 0. 05）. Multiple linear regression showed that HbAlc, TG and HOMA-IR were independently associated with plasma CTRP3 level （ P 〈 0.05 ）. Conclusion The plasma level of CTRP3 is significantly lower in both the obese and T2DM patients than normal subjects. CTRP3 is closely associated with obesity, glycolipid disorder, inflammation and insulin resistance. HbA1 c, TG and HOMA-IR are independent factors of plasma CTRP3. CTRP3 may

关 键 词：补体C1Q 肿瘤坏死因子相关蛋白-3 肥胖 2型糖尿病 胰岛素抵抗 

分 类 号：R341[医药卫生—基础医学] R446.112