2型糖尿病一级亲属中血清抵抗素、内脂素与胰岛素抵抗及胰岛p细胞功能的相关性研究

目的 了解2型糖尿病(T2DM)患者不同糖代谢状态的一级亲属血清抵抗素(RES)、内脂素(VIS)与胰岛素抵抗(IR)和胰岛β细胞功能的关系,并探讨其在T2DM发病中的作用以及临床检测的意义.方法 收集既往无糖耐量异常史的T2DM一级亲属229例,其中经75 g葡萄糖耐量试验分为糖耐量正常(NGT组)174例、空腹血糖受损(IFG)或糖耐量低减(IGT)(IFG/IGT组)55例,收集71例新发T2DM(T2DM组);同时收集上述一级亲属配偶或亲友中无糖尿病家族史的糖耐量正常者114例作为正常对照组.酶联免疫法测定上述人群的血清空腹真胰岛素(FTI)、胰岛素原(FPI)、RES和VIS水平,用HOMA-IR评价IR状态,以HOMA-β及空腹PI和PI/TI比值评价β细胞功能,同时进行人体测量学、脂代谢、肝肾功能、血尿酸及生活习惯的调查.结果 (1)血清RES水平各组间差异无统计学意义(P＞0.05),与HOMA-IR、HOMA-β和肥胖指标均未见相关性(P＞0.05).(2)T2DM组、IGT/IFG组和NGT组较正常对照组血清VIS水平降低(P＜0.05);T2DM组、IGT/IFG组和NGT组之间差异无统计学意义.血清VIS水平与HOMA-IR、肥胖指标未见相关性(P＞0.05),与空腹和2 h血糖、血压负相关(P＜0.05).结论 T2DM一级亲属在糖耐量异常发生前,具有改善糖代谢作用的VIS水平明显降低,提示上述脂肪细胞因子在IR的形成及T2DM的发病中起一定作用

Association between both resistin visfatin and insulin resistance as well as 8 cell function in the first-degree relatives of type 2 diabetes mellitus

Objective To study the association between the levels of scrum resistin, visfatin and insulin resistance as well as β-cell dysfunction in the first-degree relatives (FDR) of type 2 diabetes mellitus (T2DM), and to investigate the role of these adipocytokins in pathogenesis of T2DM. Methods Serum levels of resistin, visfatin as well as fasting true insulin (FTI), proinsulin (FPI) levels were measured in 71 patients with newly diagnosed T2DM. 55 subjects with IGT/IFG and 174 NGT from first-degree relatives of T2DM, and 114 subjects of NGT without T2DM family history served as control group (NC). Insulin resistance was assessed by the homeostasis model assessment (HOMA-IR) and β-cell function was evaluated by HOMA-β and fasting PI-to-TI ratio (FPI/TI). Lipid profile, liver function and kidney function were also tested. Anthropometrical parameters such as body mass index (BMI), waist circmference and blood pressure were also recorded and life style and food intake spectrum investigated. Results (1)There were no significant differences of serum resistin levels among the four groups (P ＞ 0.05 ). The serum resistin level was not correlated with HomA-IR, HomA-β and obesity markers (P＞0.05). (2) The serum visfatin levels of DM group, IGT/IFG and NGT group were lower than the NC group (P＜0.05). There were no significant difference among DM group, IGT/IFG group and NGT. The serum visfatin level was not correlated with HOMA-IR and obesity markers (P＞0.05) , but negatively correlated with fasting blood glucose, 2 h postprandial blood glucose and blood pressure (P＜0.05). Conclusion The adipokine profile in FDRs of T2DM had distinctively altered before the development of impaired glucose tolerance. Serum levels of visfatin, showed a favorable effect on glucose metabolism also had a significant decrease on serum levels in the early stage of T2DM.