新诊断2型糖尿病患者脂肪细胞因子水平与代谢综合征的关系

目的 探讨新诊断2型糖尿病患者血清脂联素及视黄醇结合蛋白4(RBP4)水平与代谢综合征(MS)的关系. 方法分别将糖尿病组及对照组分为年龄≥60岁组及<60岁组,根据2004年中华医学会糖尿病学会提出的关于MS的定义将对照组及糖尿病组分为不同代谢异常组.采用ELISA法测定95例新诊断2型糖尿病患者(糖尿病组)与55例非精尿病者(对照组)空腹血清脂联素、RBP4浓度,同时检测血糖、血脂、血压、血清胰岛素水平,采用胰岛素抵抗指数(HOMA-IR)评价各组胰岛素敏感性,分析各项指标与脂联素、RBP4的相关性. 结果 (1)糖尿病组与对照组比较,血清脂联素水平显著降低,分别为(7.26±4.69)mg/L和(11.93±4.89)mg/L;RBP4水平显著升高,分别为(16.48±7.82)mg/L和(10.91±5.26)mg/L;(2)糖尿病组与对照组比较,MS患病率显著增高,分别为46.3%和7.3%;(3)随着MS组分的增多,脂联素含量均呈下降趋势,而RBP4水平呈升高趋势;(4)糖尿组血清脂联素与MS、腰围、体质指数呈负相关,RBP4与腰围、HOMA-IR、体质指数、MS、三酰甘油呈正相关. 结论血清脂联素、RBP4与MS密切相关,低脂联素血症、高RBP4在MS发病中可能具有重要的作用.

Relationship between adipose cytokines and metabolic syndrome in newly diagnosed type 2 diabetes mellitus patients

Objective To investigate the relationship between serum levels of adiponectin (APN) and retinol binding protein 4 (RBP4) in newly diagnosed type 2 diabetes mellitus (T2DM) patients. Methods 95 newly diagnosed T2DM patients and 55 non-diabetic volunteers from health examination population were studied. The serum concentrations of APN and RBP4 were determined by ELISA. The levels of plasma glucose, lipid profiles and insulin were also measured in fasting samples. Insulin sensitivity was assessed by insulin resistance index (HOMA-IR). The control group and diabetic group were divided into ≥60 years subgroup and <60 years subgroup respectively. According to the guideline designed by Chinese Diabetes Society(CDS)in 2004, the control group and diabetic group were divided into different kinds of abnormal metabolism groups. Results (1)The level of APN was significantly decreased in diabetic group compared with the control group[(7.26±4.69)mg/L vs. (11.93±4.89)mg/L], while the serum level of RBP4 in diabetic group was obviously higher than that in control group[(16.48±7.82) mg/L vs. (10.91±5.26) rag/L]. (2) The prevalence of metabolic syndrome in diabetic group was higher than that in control group (46.3% vs. 7.3%). (3)APN level was decreased with the increasing number of components of MS, and RBP4 level was increased with the increasing number of components of MS. (4) In DM group, APN level was correlated negatively with MS, waist circumference and BMI, and RBP4 level was correlated positively with waist circumference, HOMA-IR, BMI and TG. Conclusions APN and RBP4 levels are significantly associated with metabolic syndrome. Hypoadiponectinemia and higher retinal binding protein 4 may play an important role in the pathogenesis of MS.