摘要
目的研究2型糖尿病(type 2 diabetes mellitus,T2DM)家族血清vaspin(脂肪特异性丝氨酸蛋白酶抑制剂)水平与瘦素、hs-CRP及炎症因子之间的相关性。方法按WHO 1999年推荐的T2DM诊断与分型标准及OGTT标准,从2017-01~2017-12选择我院门诊或住院患者以及体检部健康人群共360人,分为:DM组(n=120),T2DM患者,且其家族中与其有血缘关系的T2DM患者≥2人;NFDR组(n=120),T2DM患者的一级亲属中糖耐量正常者;NC组(n=120),与T2DM患者无血缘关系且糖耐量正常的健康人群。每组按体质量指数(body mass index,BMI)再分为两组:肥胖(BMI≥25 kg/m^2)组和非肥胖(BMI<25 kg/m^2)组。测量其腰围、臀围、身高、体质量,计算腰臀比及BMI,测定体脂百分比,检测空腹血糖、75 g葡萄糖负荷后餐后2 h血糖(OGTT 2 h)、糖化血红蛋白、空腹胰岛素、甘油三酯、总胆固醇、低密度脂蛋白和高密度脂蛋白,计算稳态模型的胰岛素抵抗指数(HOMA-IR),采用酶联免疫吸附法测定空腹血清vaspin浓度,以及炎症因子IL-1、IL-6、肿瘤坏死因子α(TNF-α)及超敏C反应蛋白(hs-CRP)、瘦素水平。结果 vaspin、IL-6、TNF-α和瘦素浓度在DM组、NFDR组和NC组中呈递减趋势,且三组间差异有统计学意义(P<0.05)。DM组、NFDR组和NC组三组中肥胖者的vaspin水平均比非肥胖者明显升高,DM组的非肥胖者vaspin水平比NFDR组和NC组的非肥胖者明显升高,组间差异均具有统计学意义(P<0.05)。线性回归分析发现DM组中vaspin水平与IL-6、TNF-α和瘦素呈正相关(回归系数β分别为1.634,1.932,1.843,P值分别为0.036,0.015,0.035),vaspin水平与IL-1和hs-CRP水平没有相关性(回归系数β分别是1.536,1.754,P值分别为0.054,0.072)。结论 T2DM家族血清vaspin水平与炎症因子IL-6、TNF-α及瘦素相关,vaspin可能在T2DM炎症反应等方面发挥着重要的作用。
Objective To explore the association of serum vaspin concentrations between leptin, hypersensitive C reactive protein and inflammatory markers in type 2 diabetes family.Methods According to the criteria of diagnosis and classification and the OGTT standard recommended by WHO in 1999, a total of 360 individuals in outpatient or inpatient department and physical examination department were chosen and divided into three groups： DM group（ n =120, T2DM patients with more than 2 related T2DM patients in a family）, NFDR group（ n =120,first-degree relatives of T2DM patients and normal glucose tolerance）, NC group（ n =120, unrelated healthy controls with normal glucose tolerance）. Each group was divided into normal weight control subgroup（BMI〈25 kg/m 2） and overweight or obese control subgroup（BMI≥25 kg/m 2）. Waist and hip circumference, height, weight, waist hip ratio（WHR）, BMI, the percentage of body fat, fasting blood glucose, 2 h postprandial blood glucose after 75 g glucose load（OGTT 2 h）, glycosylated hemoglobin, fasting insulin, triglyceride, total cholesterol, low density lipoprotein and high density lipoprotein were measured, and the index of insulin resistance（HOMA-IR） was calculated. Serum vaspin concentrations and inflammatory factors IL-1, IL-6, tumor necrosis factor alpha（TNF-α） and hypersensitivity C reactive protein（hs-CRP）, leptin levels were measured by enzyme-linked immunosorbent assay.
Results The concentrations of vaspin, IL-6, TNF-α and leptin were gradually decreased in DM group, NFDR group and NC group, and the difference between the three groups was statistically significant（ P 〈0.05）. The vaspin level in obese subjects was significantly higher than that of non-obese subjects in DM group, NFDR group and NC group. The vaspin level of non-obese subjects in DM group was significantly higher than that in NFDR group and NC group（ P 〈0.05）. Linear regression analysis showed that vaspin level in DM group was positively correlated with IL-6, TNF-α and leptin（ β =1.634, 1.932, 1.843, P =0.036, 0.015, 0.035,respectively）, and that vaspin level was not related to IL-1 and hs-CRP levels （regression coefficient β =1.536, 1.754, P =0.054, 0.072, respectively）.
Conclusion Serum vaspin concentration is positively correlated with inflammatory factors and leptin of T2DM family. Vaspin may play an important role in inflammatory reaction in T2DM.
作者
孙明珠
李秀丽
权晓娟
于俊霞
SUN Mingzhu;LI Xiuli ＊;QUAN Xiaojuan;YU Junxia(Department of Endocrinology,Second Affiliated Hospital of Medical School of Xi’an Jiaotong University,Xi’an 710004,China)
出处
《山西医科大学学报》
CAS
2018年第6期664-669,共6页
Journal of Shanxi Medical University
基金
陕西省自然科学基础研究计划项目(2014JM4163)
