新诊断2型糖尿病患者血清高分子量脂联素水平及其影响因素分析  

Changes of serum high-molecular-weight adiponectin levels and related factors in patients with newly diagnosed type 2 diabetes mellitus

作　　者：俞淑琴 钱唯韵[1] 汤冰倩[1] 朱天一[1] 胡浩[1] 孙文君[1] 王济芳[1] 杨玲[1] 王东[1] 潘瑞蓉[1] 袁国跃[1] 

机构地区：[1]江苏大学附属医院内分泌代谢科,镇江212001

出　　处：《中国糖尿病杂志》2015年第2期119-122,共4页Chinese Journal of Diabetes

基　　金：国家自然科学基金面上项目(81370965);江苏省自然科学基金项目(BK2009208);江苏省卫生厅国际交流支撑计划及面上科技项目(H201247);镇江市社会发展项目(SH2013035;SH2012027)

摘　　要：目的观察新诊断T2DM患者血清高分子量脂联素（HMW-APN）水平,探讨其与糖脂代谢、IR及胰岛β细胞功能的关系。方法 176例研究对象,根据75g OGTT结果分为新诊断T2DM组88例和NGT组88名,两组再以BMI 25kg/m^2为切点分为正常体重（NW）亚组和肥胖（OB）亚组。检测各组HbA1c、血糖、胰岛素、血脂及HMW-APN水平。结果T2DM组血清HMW-APN水平低于NGT组[0.99（0.52-1.56）vs 2.53（1.69-5.44）ng/L]（P〈0.01）。T2DM组和NGT组的OB亚组HMW-APN水平均低于同组内NW亚组[0.74（0.35-1.39）vs 1.21（0.74-2.08）ng/L;2.11（1.47-4.01）vs 4.49（2.40-6.11）ng/L]（P〈0.05）。相关性分析提示,HMW-APN与BMI、WC、WHR、SBP、TG、FPG、2hPG、HbA1c、FIns、2hIns、胰岛素抵抗指数（HOMA-IR）、高敏C反应蛋白（hsC-RP）呈负相关（P〈0.05或P〈0.01）,与HDL-C、胰岛β细胞功能指数（HOMA-β）呈正相关（P〈0.01）。多元逐步回归分析提示,2hPG、hsC-RP及WHR是血清HMW-APN水平的独立影响因素。结论血清HMWAPN水平在新诊断T2DM患者中降低,其与肥胖、糖脂代谢、IR、胰岛β细胞功能及hsC-RP密切相关,提示血清HMW-APN下降可能参与了肥胖和T2DM的发生发展。Objective To investigate the change of serum high-molecular-weight adiponectin（HMWAPN）level in newly diagnosed type 2 diabetes mellitus（T2DM）patientsand investigate the relationships between serum HMW-APN level and glycolipid metabolism,insulin resistance and pancreasβcell function.Methods A total of 176 Chinese subjects were enrolled in the study,including eighty-eight patients with newly-diagnosed T2DM and eighty-eight subjects with normal glucose tolerance（NGT）.NGT and T2DM groups were further divided into normal weight（NW）and obese（OB）subgroups separately.Obesity was defined as BMI≥25kg/m^2 according to the WHO-Western Pacific Region diagnostic set forth in 2000.75 g oral glucose tolerance test（OGTT）was performed in all subjects.HbA1 c,blood glucose,blood insulin,blood lipids and HMW-APN level were also determined. Results The serum HMW-APN level was significantly lower in T2DM group than in NGT group[0.99（0.52-1.56）vs 2.53（1.69-5.44）ng/L,P0.01].Within subgroups of T2DM and NGT,serum HMW-APN level was lower in OB subgroups than in NW subgroups[0.74（0.35-1.39）vs 1.21（0.74-2.08）ng/L;2.11（1.47-4.01）vs 4.49（2.40-6.11）ng/L,P0.05].Pearson correlation analysis showed that serum HMW-APN level was negatively correlated with BMI,WC,WHR,SBP,TG,FPG,2hPG,HbA1 c,FIns,2hIns,HOMA-IR and hsC-RP（P0.05 or P0.01）,and was positively correlated with HDL-C and HOMA-β（P0.01）.Multiple linear regression analysis showed that 2hPG,hsC-RP and WHR were independently related to serum HMWAPN level（P〈0.01）. Conclusion Serum HMW-APN level is decreased in subjects with newly diagnosed T2 DM.Serum HMW-APN level is closely correlated with obesity,glycolipid metabolism,insulin resistance,pancreasβcell function and hsC-RP.It suggests that the HMW-APN decline may be play an importantrole in the pathogenesis of obesity and T2DM.

关 键 词：新诊断 糖尿病 2型 高分子量脂联素 高敏C反应蛋白 

分 类 号：R587.1[医药卫生—内分泌]