2型糖尿病大血管病变与血浆脂联素的相关研究

目的　探讨2型糖尿病及糖尿病大血管病变中血浆脂联素(adiponectin，APN)的变化及相关性。方法　选取健康对照组42例（G1组），单纯2型糖尿病(T2DM)患者43例（G2组）,2型糖尿病合并下肢动脉病变组39例（G3组）。对所有研究对象常规行空腹血糖(FPG)、高密度脂蛋白（HDL）、甘油三酯(TG)、糖化血红蛋白(HbA1c)、空腹C肽（C-P）、空腹胰岛素(FINS)和血浆APN水平测定，计算体质指数(BMI)及胰岛素敏感指数(ISI)，并对各组间临床指标进行比较，对各指标与脂联素水平的相关性进行相关分析。结果 与对照组比较，2型糖尿病患者FPG、TG、HDL、FINS、BMI、C-P、APN和HbA1c水平明显高于对照组( P＜0.05或P＜0.01)，APN、C-P水平及ISI值糖尿病合并大血管病变组明显低于单纯糖尿病组和对照组(P＜0.01)；2型糖尿病病人血浆APN水平与下肢血管病变、FPG、C-P、TG及BMI显著负相关，与HDL及ISI呈显著正相关。结论:血浆APN在2型糖尿病患者中明显降低，合并大血管病变患者降低更明显，提示血浆APN水平降低可能是发生糖尿病及糖尿病大血管病变的一个独立危险因素。

Association of Plasma Adiponectin in the Type 2 Diabetic Mellitus Patients with Macrovasvular Complications

Objective : To explore the association between the changes of blood plasma adiponectin level in patients with type 2 diabetes complicated with macrovascular artherosclerosis.Methods: In a cross sectional study, All subjects randomly recruited in were divided into normal control group 42 cases(G1) , group of type 2 diabetes without artherosclerosis 43 cases(G2) ang group of type 2 diabetes with artherosclerosis 39 cases(G3).We measured adiponectin through RIA,The parameters of fasting plasma glucose(FPG), High-density lipoprotein(HDL) and triglyceride (TG), fasting C-reactive protein(C-P),fasting insulin level in plasma (FINS) and glycosylated hemoglobin (HbA1c) were measured, Insulin sensitive index(ISI) and bodymass index (BMI)were calculated, All calculationswere performed using the SPSS 11.0 version for Windows. Results: Compared the clinical index among the three groups, the level of FPG,TG,FINS,C-P,APN and BMI in type 2 diabetes mellitus patients were significantly higher(P＜0.01) and the concentration of plasma adiponectin and the level of ISI and HDL were significantly lower(P＜0.01) than in the controls, and the concentration of plasma adiponectin is much lower in the group of type 2 diabetes with artherosclerosis than in group of type 2 diabeteswithout artherosclerosis1 the level of plasma adiponectin was correlated positivelywith ISI and HDL(P＜0.01) and negativelywith FPG, TG, C-P,BMI and macrovascular artherosclerosis (P＜0.01). Conclusion：The levels of plasma adiponectin in type 2 diabetic patient with macrovascular complications is significantly decreased.There may be relations between plasma concentrations of adiponectin and the occurrence of type 2 diabetic patient and macrovascular artherosclerosis.