女性腹型肥胖患者低脂联素血症与胰岛β细胞功能关系探讨

目的：探讨女性腹型肥胖患者脂联素水平与胰岛β细胞功能之间的关系。方法：应用高葡萄糖钳夹技术检测了9例女性腹型肥胖、9例健康女性对照和7例女性2型糖尿病患者的胰岛G细胞功能和胰岛素敏感性，用MRI测定局部体脂和酶联免疫法测定脂联素水平。结果：对照组胰岛素分泌第一时相（FPIR）、葡萄糖代谢清除率（GDR）、胰岛素敏感性指数（ISI）和脂联素水平高于腹型肥胖组和2型糖尿病组；内脏脂肪面积（VA）低于腹型肥胖组和2型糖尿病组（P〈0．05）。腹型肥胖组脂联素、FPIR、胰岛素分泌第二时相（SPIR）和胰岛素分泌最大量（INSmax）高于2型糖尿病组（P〈0．05）。多元逐步回归分析显示，年龄、FPIR和GDR与脂联素呈独立正相关（B分别为0．145、0．194、0．277，均P〈0．05）；腰臀比（WHR）与脂联素呈独立负相关（B为-7．424，P〈0．05）。砖论：腹型肥胖女性脂联素水平降低，可能与胰岛素分泌密切相关。

Relationship between adiponectin and beta-cell function in abdominal visceral obesity women

OBJECTIVE: To investigate the relationship between adiponectin and beta-cell function in abdominal visceral obesity women. METHODS: Nine abdominal visceral obesity women (VO), 9 normal subjects (C) and 7 patients with type 2 diabetes mellitus (T2DM) were enrolled in the study. Beta-cell function and insulin sensitivity were determined by hyperglycemic clamp, fasting serum adiponectin was assayed by ELISA and regional body fat was measured by MRI. RESULT: The levels of first phase insulin release (FPIR), glucose disposal rates (GDR), insulin sensitivity index (ISI) and adiponectin were significantly elevated in control group compared with VO group and T2DM group. As compared with T2DM group, the levels of adiponectin, FPIR, second phase insulin release (SPIR) and maximum insulin release (INS(max)) increased significantly in VO group. Multiple stepwise regression analysis showed that age, FPIR and GDR were positively correlated to adiponectin (B=0.145, 0.194, 0.277 respectively, all P<0.05), while waist-hip ratio was negatively correlated with adiponectin (B=-7.424, P<0.05). CONCLUSION: The visceral obesity women have lower adiponectin levels, and hyperadiponectinemia may be the link with insulin secretion.