早期2型糖尿病患者血清内脂素与瘦素的变化及相关性分析

目的 了解初诊断2型糖尿病患者血清内脂素、瘦素水平变化,探讨内脂素与各项代谢指标之间的相关性.方法 选取新诊断或患病时间短的2型糖尿病者(n=57)与健康人群(n=61例)进行对比,根据BMI分为超重亚组和正常体重亚组,检测内脂素和瘦素水平,并检测胰岛素、血糖、糖化血红蛋白等相关生化指标,测量人体腰臀比、体重指数等参数,分析内脂素与上述指标的关系.结果 糖尿病组FPG HbA1C HOMA-IR TC TG WHR较健康对照组升高,两者差异有统计学意义(P＜0.01),Fins LDL-C HDL-C BMI两组差异无统计学意义(P＞0.05)；糖尿病组检测的内脂素、瘦素较NGT稍高,但差异无统计学意义(P＞0.05)；每组中超重亚组瘦素较体重正常亚组间升高,差异有统计学意义(P＜0.01)；而内脂素虽升高但差异无统计学意义(P＞0.05)；内脂素与瘦素以及其他临床指标相关分析提示糖尿病组内脂素与WHR HbA1C呈负相关(r=-0.34,和r=-0.26),与瘦素及其他参数包括BMI、HOMA-IR无明显相关.结论 内脂素的升高与脂肪组织分布特点(如女性下半身肥胖)的关系更密切；并推测内脂素可能是糖尿病病理生理中的一种代偿机制.瘦素仅与体重状态有关,非糖尿病发病独立因素.

Changes and correlation of serum visfatin,leptin levels in patients with type 2 diabetes mellitus of newly diagnosis

OBJECTIVE To examine the change of serum levels of visfatin and leptin in patients with type 2 diabetes mellitus of newly diagnosis,and evaluate the relationship between visfatin and biochemical parameters in persons with diabetes mellitus.METHODS Healthy participants(n = 57) and T2DM(n = 61) were divided into two groups:overweight group and normal weight group.Fasting plasma visfatin,leptin and related clinical variables were detected.RESULTS FPG,HbA1C,HOMAIR,TC,TG,WHR of T2DM were higher than those of controls(P﹤0.01).Visfatin and leptin in T2DM subjects was modestly higher than in normal subjects,but the difference was not significant.The levels of leptin in the overweight group were higher than the normal’s(P﹤0.01).Plasma visfatin level was negatively correlated with WHR and HbA1C(r =-0.34 and r =-0.26).No statistically significant correlations were found between visfatin levels and remaining parameters in study.CONCLUSION The result may suggest that elevated vidgatin levels are associated with the distribution characteristic of adipose tissue.Visfatin may be a compensatory mechanism in part of the pathophysiology of diabetes.Level of leptin is not the independent risk factor in development of T2DM.