2型糖尿病合并冠心病患者血浆CTRP9水平和胰岛素抵抗的相关性研究  

Study on correlation between plasma CTRP9 level with insulin resistance in patients with type 2 diabetes mellitus complicating coronary heart disease

作　　者：王葱[1] 李生兵[1] 

机构地区：[1]重庆医科大学附属第二医院内分泌科,重庆400010

出　　处：《现代医药卫生》2016年第1期1-4,共4页Journal of Modern Medicine & Health

基　　金：国家自然科学基金青年科学基金资助项目(81501199)

摘　　要：目的检测2型糖尿病(T2DM)合并冠心病(CHD)患者血浆C1q/肿瘤坏死因子相关蛋白9(CTRP9)水平,探讨CTRP9与胰岛素抵抗的关系。方法选取2014年1月至2015年8月该院收治的单纯T2DM患者39例(T2DM组)、T2DM合并CHD患者32例(T2DM+CHD组)、单纯CHD患者36例(CHD组)、健康体检者40例(HC组),均采用酶联免疫吸附试验(ELISA)法测定空腹血浆CTRP9水平,分析血浆CTRP9水平与体质量指数(BMI)、腰臀比(WHR)、收缩压(SBP)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞分泌指数(HOMA-β)、三酰甘油(TG)等指标的关系。结果 T2DM组、CHD组血浆CTRP9水平[分别为(128.24±12.77)、(116.73±10.36)ng/m L]显著低于HC组[(176.31±21.57)ng/m L],T2DM+CHD组血浆CTRP9水平[(89.91±9.01)ng/m L]显著低于CHD组和T2DM组,差异均有统计学意义(P<0.05)。血浆CTRP9水平与BMI、WHR、SBP、空腹血糖、餐后2小时血糖、糖化血红蛋白、空腹胰岛素、餐后2小时胰岛素、HOMA-IR和TG呈负相关(r=-0.541、-0.212、-0.234、-0.308、-0.361、-0.377、-0.282、-0.247、-0.492、-0.329,P<0.01),与高密度脂蛋白胆固醇和HOMA-β呈正相关(r=0.323、0.415,P<0.01),而与年龄、性别无关(r=0.046、0.103,P>0.05)。HOMA-IR和BMI是血浆CTRP9水平的独立影响因素(P<0.05)。结论 T2DM合并CHD患者血浆CTRP9水平显著降低,且与胰岛素抵抗密切相关。Objective To detect plasma C1q/tumor necrosis factor related protein 9（CTRP9） level in the patients with type 2 diabetes mellitus（T2DM） complicating coronary heart disease（CHD） and to investigate its relation with insulin resistance.Methods 39 cases of pure T2DM（T2DM group）,36 cases of pure CHD（CHD group）,32 cases of T2 DM complicating CHD（T2DM＋CHD group） and 40 individuals undergoing the healthy physical examination（HC group） were selected. Fasting plasma CTRP9 level was determined by ELISA. Meanwhile,the relationship between plasma CTRP9 level with the body mass index（BMI）,waist-hip ratio（WHR）,systolic blood pressure（SBP）,homeostasis model assessment of insulin resistance（HOMA-IR）,HOMA-β and TG was analyzed. Results The levels of plasma CTRP9 were significantly decreased in the T2 DM group and CHD group than those in the HC group[（128.24±12.77）ng/m L vs.（176.31±21.57）ng/m L,（116.73±10.36）ng/m L vs.（176.31±21.57）ng/m L,P〈0.05]. Compared with CHD group and T2 DM group,the level of plasma CTRP9 in the T2DM＋CHD group was significantly decreased,the differences were statistically significant[（116.73±10.36）ng/m L,（128.24±12.77）ng/m L vs.（89.91±9.01）ng/m L,P〈0.05].The plasma CTRP9 level was negatively correlated with BMI,WHR,SBP,FPG,2h PG,Hb A1 c,FINS,PINS,HOMA-IR and TG（r =-0.541,-0.212,-0.234,-0.308,-0.361,-0.377,-0.282,-0.247,-0.492,-0.329,P〈0.01）,and positively correlated with HDL-C and HOMA-β（r=0.323,0.415,P〈0.01）. But there were no correlation between the plasma CTRP9 with age and sex（r=0.046、0.103,P〉0.05）. HOMA-IR and BMI were independent influence factors of plasma CTRP9 level（P〈0.05）. Conclusion Plasma CTRP9 level in the patients with T2 DM complicating CHD is significantly decreased and closely related with insulin resistance.

关 键 词：补体系统蛋白质类 肿瘤坏死因子类 胰岛素抗药性 糖尿病 2型 冠心病 

分 类 号：R587.1[医药卫生—内分泌]