初发2型糖尿病合并肥胖患者血清网膜素及脂联素水平的变化  

The changes of serum omentin and adiponectin in newly diagnosed type 2 diabetic mellitus combined obese patients

作　　者：张漫漫[1] 班博[2] 陈京[3] 龚磊[3] 

机构地区：[1]山东大学医学院,山东济南250012 [2]济宁医学院附属医院内分泌科 [3]济宁医学院神经生理研究所

出　　处：《中国老年学杂志》2015年第5期1153-1155,共3页Chinese Journal of Gerontology

基　　金：国家自然科学基金资助项目(No.31271243);山东省自然科学基金资助项目(No.ZR2009CZ006)

摘　　要：目的探讨初发2型糖尿病(T2DM)及肥胖患者血清网膜素和脂联素水平的变化及意义。方法 100例T2DM和80例正常糖调节者(NGR),按体重指数(BMI)≥25 kg/m2分为正常体重和肥胖亚组,采用酶联免疫吸附(ELISA)法检测空腹血清网膜素及脂联素水平,同时检测空腹血糖(FPG),口服糖耐量试验2 h血糖(OGTT-2 h PG),糖化血红蛋白(Hb A1c)、血脂各项指标及空腹胰岛素(FINS)水平,计算BMI、腰臀比值(WHR),并以稳态模型(HOMA-model)计算胰岛素抵抗指数(HOMA-IR)。结果 T2DM组的血清网膜素、脂联素水平均低于NGR组(均P<0.05),其中两组中的肥胖亚组均低于非肥胖者(均P<0.05),且T2DM-OW组明显低于NGR-OW组。相关分析显示,血清网膜素水平与BMI、WHR、FPG、2h PG、总胆固醇(TC)、甘油三酯(TG)、FINS、HOMA-IR、TC/HDL呈负相关,与性别、高密度脂蛋白(HDL)、脂联素呈正相关;血清脂联素水平与收缩压(SBP)、BMI、WHR、FPG、2 h PG、TG、FINS、HOMA-IR、TC/HDL呈负相关,与HDL、网膜素呈正相关。多元逐步回归分析,TC/HDL、HDL和HOMAIR是血清网膜素的独立相关因素。FPG、BMI、TC/HDL和HOMA-IR是血清脂联素的独立相关因素。结论网膜素及脂联素可能通过多种途径参与了糖尿病及肥胖的病理过程;网膜素可能协同脂联素在T2DM及肥胖患者中发挥抗动脉粥样硬化作用。Objective To investigate the changes and significance of serum omentin and adiponectin levels in newly diagnosed type2 diabetic mellitus patients( T2DM) combined obese patients.Methods 100 newly diagnosed T2DM patients were divided into normal weight( T2DM-NW)( n = 50,BMI < 25 kg/m2) and obese( T2DM-OB) subgroups( n = 50,BMI≥25 kg/m2).80 patients with normal glucose regulation( NGR) were subdivided into normal weight( NGR-NW)( n = 41,BMI < 25 kg/m2) and obese( NGR-OB) subgroups( n =39,BMI≥25kg/m2).The levels of fasting serum omentin,adiponectin were assessed by ELISA.Blood glucose,Hb Alc,lipids and insulin levels were also measured.Insulin sensitivity was assayed by HOMA-IR.Results The serum levels of omentin,adiponectin in T2DM group were significantly lower than those in NGR group〔( 15.64 ± 9.64) ng / ml vs( 22.9 ± 7.75) ng / ml,( 7.28 ± 3.31) μg / ml vs( 9.7 ± 4.15)μg /ml,P < 0.05〕.The serum omentin,adiponectin levels of the obese subjects were significantly lower than those of the NW subjects.Partial correlation analysis showed: the serum omentin was negatively correlated to BMI,WHR,FPG,2h PG,TC,TG,FINS,TC / HDL,HOMAIR,and positively correlated to sex,HDL,adiponectin.The serum adiponectin was negatively correlated to BMI,WHR,FPG,2h PG,TC,TG,FINS,TC / HDL,HOMA-IR,and positively correlated to HDL and omentin.Multiple linear regression showed that TC / HDL,HDL and HOMA-IR were independent variables of omentin,and that FPG,BMI,TC / HDL,HOMA-IR were independent variables of adiponectin.Conclusions The levels of serum omentin and adiponectin are significantly changed in newly diagnosed T2DM combined obese patients,which may be involved in the pathological process of T2DM and obese through many ways; omentin may in coordination with adiponectin play a role of anti-atherogenesis in obese and T2DM patients.

关 键 词：网膜素 脂联素 肥胖 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]