2型糖尿病合并肥胖患者脂联素水平与胰岛素抵抗的相关性

目的 研究2型糖尿病合并肥胖患者脂联素水平和胰岛素抵抗之间的相关性,探讨脂联素在2型糖尿病合并肥胖患者发生胰岛素抵抗中的作用.方法 选择30例2型糖尿病合并肥胖患者、25例2型糖尿病患者及25例非糖尿病对照人员(其中13例为肥胖者),检测体质指数、腰/臀比值、空腹血糖、糖化血红蛋白、血清空腹胰岛素、血脂、脂联素水平,计算胰岛素抵抗指数和胰岛素敏感指数.分析血清脂联素与胰岛素抵抗的相关性.结果 (1)糖尿病肥胖组的检测体质指数、糖化血红蛋白、空腹血糖、胰岛素抵抗指数、血清空腹胰岛素、腰/臀比值均高于对照肥胖组,脂联素、胰岛素敏感指数低于对照肥胖组(P<0.05).(2)糖尿病非肥胖组甘油三酯、糖化血红蛋白、空腹血糖、胰岛素抵抗指数、血清空腹胰岛素均高于对照非肥胖组,胰岛素敏感指数、脂联素低于对照非肥胖组(P<0.05).(3)糖尿病肥胖组甘油三酯、胆固醇、体质指数、糖化血红蛋白、空腹血糖、胰岛素抵抗指数、血清空腹胰岛素、腰/臀比值均高于糖尿病非肥胖组,胰岛素敏感指数、脂联素低于糖尿病非肥胖组(P<0.05).结论 脂联素与2型糖尿病肥胖患者的胰岛素抵抗发生有关,脂联素降低易导致胰岛素抵抗,脂联素水平可作为2型糖尿病合并肥胖患者发生胰岛素抵抗的监测标准.

The Study of Relationship Between Adiponectin and Insulin Resistance in Type 2 Diabetic Patients with Obesity

Aim To study the association between serum adiponectin and insulin resistance in the type 2 diabe-tes mellitus patients with obesity, and investigate the role of serum adiponectin in the type 2 diabetes mellitns patients with obesity who had insulin resistance. Methods 30 T2DM patients with obesity, 25 T2DM patients, and 25 controls which included 13 with obesity were selected. Their body mass index ( BMI), waistline, fasting plasma glucose (FPG), hemoglobin al c( HbA1 c) , fasting insulin ( FINS) , and the serum levels of total cholesterol, triglyceride and adioponectin were measured. Then the HOMA-IR and ISI were calculated. At last, the relationships between serum adioponectin and insulin resistance were analyzed. Results (1)The BMI, HbAlc, FPG, HOMA-IR, FINS were significantly higher in diabetic obese group than control obese group, serum adiponectin and ISI was significantly lower in diabetic obese group ( P <0.05). (2)The triglyeride, HbAIc, FPG, HOMA-IR, FINS were higher in diabetic group without obesity than con-trol group without obesity, serum adipenectin and ISI was lower in diabetic group without obesity ( P < 0.05 ). ( 3 ) The triglyeride,cholesterol,HbAlc, FPG, HOMA-IR, FINS,waistline were higher in diabetic obese group than diabetic group without obesity, serum adiponeetin and ISI was lower in diabetic obese group ( P < 0.05 ). Conclusion The serum ed-iponeetin level were correlated with insulin resistance in obesity with type 2 diabetes mellitus patients. Lower adiponectin leads to insulin resistance. The level of adiponeetin can serve as an indicator in detecting insulin resistance in type 2 diabe-tes mellitus patients with obesity.