2型糖尿病合并肥胖患者血清肌联素水平与胰岛素抵抗的相关性  

Correlation between serum myonectin level and insulin resistance in overweight and obese patients with type 2 diabetes mellitus

作　　者：谷君[1] 夏楠 许峥嵘[1] 史丽[1] 邓文娟[1] 张秋子[1] 左丽娟[1] 任卫东[1] Gu Jun;Xia Nan;Xu Zhengrong;Shi Li;Deng Wenjuan;Zhang Qiuzi;Zuo Lijuan;Ren Weidong(Department of Endocrinology,First Attached Hospital of Hebei Northern Institute,Zhangjiakou Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院内分泌科,河北张家口075000

出　　处：《中国医刊》2024年第1期46-49,共4页Chinese Journal of Medicine

基　　金：2019年度河北省医学科学研究课题计划(20190875)。

摘　　要：目的 观察2型糖尿病(T2DM)合并肥胖患者血清肌联素(myonectin)水平的变化,探讨血清myonectin水平的影响因素及其与胰岛素抵抗的相关性。方法 选择2020年11月至2022年6月在河北北方学院附属第一医院内分泌科住院的186例T2DM患者,根据体重指数(BMI)分为糖尿病正常体重组(60例)、糖尿病超重组(65例)和糖尿病肥胖组(61例)。另选取同期于医院体检且BMI正常的健康者作为正常对照组(60例)。测定各组血清myonectin、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,计算BMI及稳态胰岛素抵抗指数(HOMA-IR)。比较各组血清myonectin水平,并分析血清myonectin水平与胰岛素抵抗的相关性。结果 与正常对照组比较,糖尿病正常体重组、糖尿病超重组和糖尿病肥胖组的血清myonectin水平降低,差异有统计学意义(P<0.05)。与糖尿病正常体重组比较,糖尿病超重组和糖尿病肥胖组的myonectin水平降低,差异有统计学意义(P<0.05)。与糖尿病超重组比较,糖尿病肥胖组的myonectin水平降低,差异有统计学意义(P<0.05)。多元逐步回归分析表明,影响T2DM患者BMI的主要因素为myonectin、HOMA-IR、LDL-C、HDL-C、HbA1c。影响HOMA-IR的主要因素为myonectin、BMI、HbA1c、HDL-C。结论 血清myonectin水平在T2DM合并肥胖患者中显著降低,myonectin与胰岛素抵抗密切相关,与糖脂代谢共同参与了肥胖及糖尿病的发生、发展。Objective To observe the changes of serum myonectin level in type 2 diabetes mellitus(T2DM)patients combined with overweight and obese patients,and to explore the influential factors of serum myonectin level change and its correlation with insulin resistance.Method A total of 186 patients with type 2 diabetes hospitalized in the department of endocrinology,The First Attached Hospital of Hebei Northern Institute from November 2020 to June 2022,and divided into normal diabetic body mass index group(n=60),diabetic super combination group(n=65)and diabetic obesity group(n=61)according to body mass index(BMI).Healthy subjects with normal BMI who underwent physical examination in The First Attached Hospital of Hebei Northern Institute during the same period were selected as the control group(n=60).Determine each group serum myonectin,fasting plasma glucose(FPG),Fasting serum lisulin(FINS),and hemoglobin A1c(HbA1c),total cholesterol(TC),triacylglycerol(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),BMI and homeostatic model assessment for insulin resistance(HOMA-IR)were calculated.The changes of serum myonectin in normal control group,diabetic normal weight group,diabetic super-recombination group and diabetic obesity group were compared,and the correlation between serum myonectin level and insulin resistance was analyzed.Result Compared with the normal control group,the levels of myonectin in the diabetic body mass index group,the diabetic super-recombination group and the diabetic obese group were decreased significantly(P<0.05).Compared with the normal body mass index group,the levels of myonectin in the super-recombinant diabetic group and the obese diabetic group were significantly decreased(P<0.05).The levels of myonectin in diabetic obese group were significantly lower than those in diabetic super-recombination group(P<0.05).Multiple stepwise regression analysis showed that myonectin,BMI,HbA1c and HDL-C were independent influencing factors of HOMA-IR.Conclusion Serum my

关 键 词：2型糖尿病 肥胖 超重 肌联素 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]