摘要
目的观察初诊2型糖尿病(T2DM)合并代谢综合征(MS)患者血清高分子量脂联素(HMW-APN)水平及其与胰岛素抵抗(IR)、C反应蛋白(CRP)的相关性。方法选取研究对象168例,分为健康人对照组80例及初诊T2DM患者88例;初诊T2DM患者再根据是否合并MS分为单纯T2DM组45例和T2DM合并MS组43例。研究对象均行75 g口服葡萄糖耐量试验及胰岛素释放试验,并检测血清HMW-APN、CRP、血脂等相关生化指标。结果与健康人对照组比较,T2DM合并MS组及T2DM组血清HMW-APN水平降低(P<0.01),以T2DM合并MS组最低。T2DM合并MS组及T2DM组血清CRP升高(P<0.01),以T2DM合并MS组最高。简单相关分析显示,血清HMW-APN水平与体质指数(BMI)、腰围(WC)、腰臂比(WHR)、收缩压(SBP)、空腹血糖(FPG)、餐后2小时血糖(2h PG)、糖化血红蛋白Alc(Hb A1c)、三酰甘油(TG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)及CRP呈负相关(P均<0.01),与高密度脂蛋白胆固醇(HDL-C)水平、胰岛β细胞功能指数(HOMA-β)呈正相关(P均<0.01)。多元逐步回归分析显示,WC、2h PG及CRP是血清HMW-APN水平的独立影响因素(P均<0.01)。Logistic回归分析显示,HMW-APN是T2DM发生MS的保护因素,BMI、FPG、SBP、TG是其危险因素(P<0.01或P<0.05)。结论血清HMW-APN水平在初诊T2DM合并MS患者中降低,其与IR及CRP密切相关,在初诊T2DM合并MS的发生、发展中起保护作用。
Objective To investigate the serum levels of high-molecular-weight adiponectin（ HMW-APN） in type 2 diabetes mellitus（ T2DM） patients with metabolic syndrome（ MS） and explore the relationship between HMW-APN and insulin resistance and C-reactive protein（ CRP）. Methods A total of 168 subjects were enrolled in this study,including 80 healthy subjects and 88 newly diagnosed T2 DM patients who were divided into T2 DM group（ n = 45） and T2 DM with MS group（ n = 43）. The oral glucose tolerance test（ OGTT） with 75 gram of glucose and insulin releasing test were performed in all subjects,and HMW-APN,CRP,blood lipid and other relevant items were measured simultaneously. Results Compared with normal control group,HMW-APN level was significantly decreased in T2 DM with MS group and T2 DM group,and HMW-APN in T2 DM with MS group was lower than T2 DM group（ all P〈0. 01）,and the level of CRP in T2 DM with MS group was the highest（ P〈0. 01）. HMW-APN was negatively correlated with body mass index（ BMI）,waist circumference（ WC）,waist hip ratio（ WHR）,systolic blood pressure（ SBP）,fasting plasma glucose（ FPG）,postprandial 2 hour plasma glucose（ 2h PG）,Hb A1 c,triacylglycerol（ TG）,fasting insulin（ FINS）,HOMA-IR and CRP（ P〈0. 01）,and positively correlated with HDL-C and HOMA-β（ all P〈0. 01）. Multiple linear regression analysis showed that waist circumference,CRP and 2h PG were the independent factors of HMW-APN（ all P〈0. 01）. Logistic regression analysis showed that HMW-APN was an independent protective factor for T2 DM with MS,while BMI,FPG,SBP and TG were the risk factors（ P〈0. 01 or P〈0. 05）.Conclusion The serum HMW-APN level in the newly diagnosed T2 DM patients with MS would be reduced,which was closely associated with IR and CRP. HMW-APN may play protective role in the development of T2 DM with MS.
出处
《临床检验杂志》
CAS
CSCD
2015年第5期344-348,共5页
Chinese Journal of Clinical Laboratory Science
基金
国家自然科学基金面上项目(81370965)
江苏省自然科学基金(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)
关键词
2型糖尿病
代谢综合征
高分子量脂联素
胰岛素抵抗
C反应蛋白
type 2 diabetes mellitus
metabolic syndrome
high-molecular-weight adiponectin
insulin resistance
C-reactive protein
