抵抗素（resistin）与2型糖尿病及肥胖症相关研究进展

Resistin, a new hormone found in the year 2001 and secreted by adipocytes, is related to type 2 diabetes and obesity. It brings some hope to solve the medical hamper of insulin resistance. The resistin discovery, molecule structure, function and expression, secretion regulation as well as gene polymorphism are reviewed in the article.     

2型糖尿病合并高血压患者抵抗素与动脉粥样硬化的相关性研究

为探讨2型糖尿病合并高血压患者抵抗素与动脉粥样硬化(AS)的相关性,用彩色多普勒超声技术观察2型糖尿病(A组)29例患者,2型糖尿病合并高血压(B组)23例患者及20名对照组的颈动脉内中膜厚度(IMT)及斑块的变化;应用ELISA测定血浆抵抗素水平。结果表明:A组和B组抵抗素水平较对照组显著升高(P<0.01),且B组抵抗素较A组显著升高(P<0.05);抵抗素与IMT、SBP、FBG、HOMA-IR显著正相关,与FINS显著负相关;IMT与抵抗素、年龄、BMI、SBP、FBG、FINS、HbA1c、HOMA-IR显著正相关。本文提示抵抗素参与胰岛素抵抗(IR),在AS发生及发展中起着重要作用。     

糖尿病及肥胖患者血浆瘦素水平的检测

目的: 探讨非肥胖正常人与肥胖患者及糖尿病患者血浆瘦素的关系。方法: 采用放射免疫分析法测定了21例非肥胖正常人, 24例肥胖患者及20例肥胖伴糖尿病患者血浆瘦素水平。结果: 肥胖患者血浆瘦素水平(109.1±16.4) ng/L及肥胖伴糖尿病患者血浆瘦素水平(81.0±17.5)ng/L显著低于非肥胖正常人(194.3±17.7) ng/L。结论: 非肥胖正常人及肥胖患者血浆瘦素水平与体重指数、血糖、胆固醇及甘油三脂呈显著负相关, 表明人的瘦素在调节体重及内分泌代谢方面起一定的作用。     

抵抗素在肥胖及糖尿病中的作用

Increased evidences indicate that resistin is a new hormone secreted from adipose tissue,it is reported to be an important signal molecule linking between obesity, insulin resistance and type 2 diabetes.Many factors can affect the gene expression of resistin. However, the detailed function of resistin still remainsmys terious and much work needs to be undertaken.     

抵抗素与2型糖尿病患者胰岛素抵抗的关系

研究血清抵抗素与2型糖尿病(DM)患者胰岛素抵抗(IR)的关系。应用EIA测定72例2型DM患者(非肥胖2型DM组33例,肥胖2型DM组39例)及34名健康者(对照组)的空腹血清抵抗素水平。对照组、肥胖2型DM组及非肥胖2型DM组血清抵抗素水平分别为11.0±6.5μg/L、30.2±9.5μg/L及19.1±8.3μg/L,肥胖2型DM组和非肥胖2型DM组血清抵抗素水平均显著高于对照组(P均<0.001),肥胖2型DM组血清抵抗素水平显著高于非肥胖2型DM组(P<0.001),血清抵抗素水平与2型DM患者HOMAIR指数和程度呈显著正相关(P<0.001)。     

2型糖尿病患者血清瘦素水平探讨

瘦素 (Ｌｅｐｔｉｎ)是由ｏｂ基因编码产生的一种蛋白质 ,在分泌入血的过程中去除 2 1个氨基酸组成的Ｎ -端信号肽 ,形成含 146个氨基酸的成熟的Ｌｅｐｔｉｎ[1] 。已知在正常人群中 ,血清瘦素水平与体脂分布及体重呈明显相关。糖尿病是严重影响人类健康的疾病 ,常伴有代谢紊乱、高脂血症、高血压和心脑血管疾病。本文旨在探讨非胰岛素依赖性糖尿病病人(ＮＩＤＤＭ)有无血清Ｌｅｐｔｉｎ异常 ,Ｌｅｐｔｉｎ在 2型糖尿病发病中有何作用 ,现将结果报道如下。对象和方法一、对象 :(一 )非胰岛素依赖性糖尿病病人 (ＮＩＤＤＭ)组 :5 8例 (男32 ,…     

2型糖尿病患者血清瘦素水平分析

目的：探讨２型糖尿病患者血清瘦素（Ｌｅｐｔｉｎ）水平的变化及意义。方法：采用放射免疫法测定１０９例２型糖尿病患者及８４例非糖尿病对照者的血清瘦素水平,观察其与性别、年龄、体重指数（ＢＭＩ）、腰臀比率（ＷＨＲ）、空腹血糖（ＦＰＧ）、糖化血红蛋白（ＨｂＡｌｃ）、空腹血浆胰岛素（ＦＩＮＳ）等指标的关系。结果：２型糖尿病组与对照组之间血清瘦素水平无显著性差异,但无论是在２型糖尿病患者还是对照者中,女性血清     

2型糖尿病患者血清抵抗素水平与血糖及炎症因子的相关性研究

目的 分析2型糖尿病(DM)患者血清抵抗素与血糖及炎症因子水平的关系.方法 选取本院住院部和门诊于2014年8月至2015年8月收治的患有2型DM的患者作为研究对象,将其分为4组,分别为未采用任何降糖措施的初诊2型DM患者为A组(n=32);血糖已得到控制的2型DM患者为B组(n=28),呼吸道感染的患者为C组(n=24)及健康受试者为D组(n=25),采用酶联免疫分析法对其空腹时血清抵抗素、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平进行测定,并监测空腹时的胰岛素、血糖和体重指数(BMI)及其C反应蛋白(CRP)水平.结果 A组患者的胰岛素、血清抵抗素、各种炎症因子及血糖含量均明显高于D组(P＜0.01),而B组患者的抵抗素和IL-6含量与D组受试者不具有显著性差异;C组患者的血清抵抗素和各种炎症因子水平均明显高于其余各组(P＜0.05).经相关分析,抵抗素水平与患者性别、BMI及胰岛素水平等均不相关,但与空腹血糖及炎症因子IL-6、TNF-α和CRP均呈显著的正相关性,而与TC呈显著的负相关性.结论 2型DM患者空腹时的血清抵抗素水平明显升高,且与其血糖水平相关,并可受炎症因子的影响,但与肥胖的相关性不显著.     

瘦素受体基因研究进展

瘦素受体（leptin receptor,lepr)是瘦素调节机体能量代谢和脂肪沉积的重要中介物质,在机体内广泛分布,有多种拼接异构体型。动物试验发现其基因突变与肥胖、胰岛素抵抗及糖尿病相关。关于人体瘦素受体相关基因的研究虽起步较晚。但进展较快。     

2型糖尿病患者血清瘦素水平及临床意义

目的：观察2型糖尿病（DM2）患者血清瘦素（leptin）水平及其与肥胖、血糖、血脂的关系。方法：采用放射免疫分析（RIA）测定42例DM2患者和38例正常对照组的血清leptin水平。结果：DM2组血清leptin水平明显高于对照组（P〈0．01）;血清leptin与体重指数（BMI）、血清胰岛素（INS）、总胆固醇（TC）、甘油三酯（TG）、脂蛋白LDL-C呈正相关。结论：DM2患者的高leptin血症与肥胖、血脂异常及胰岛素抵抗（IR）密切相关。     

瘦素、脂联素、抵抗素、内肥素与妊娠糖尿病胰岛素抵抗的相关性研究

目的:探讨脂肪因子瘦素、脂联素、抵抗素、内肥素与妊娠糖尿病(GDM)胰岛素抵抗的相关性.方法:实验分为正常育龄妇女组(44例)、正常妊娠妇女组(62例)和妊娠糖尿病患者组(63例),用ELISA方法分别检测3组瘦素(Leptin),脂联素(Adiponectin),抵抗素(Resistin),内肥素(Visfatin)的水平,用葡萄糖氧化酶法检测血糖水平,免疫发光法检测胰岛素水平,用HOMA-IR(稳态模型胰岛素抵抗指数)表示胰岛素抵抗状态,HOMA-IR=空腹血糖×空腹血胰岛素÷22.5,用SPSSll.5统计软件进行统计分析.结果:妊娠糖尿病患者组的瘦素水平明显高于正常妊娠妇女组[(13.50±7.14)ng/ml、(7.78±3.82)ng/ml,P<0.001],正常妊娠妇女组明显高于正常育龄妇女组[(7.78±3.82)ng/ml、(1.73±0.70)ng/ml,P<0.001]差异具有统计学意义;GDM 组的内肥素水平明显低于正常妊娠妇女组[(15.67±5.78)ng/ml、(22.43±5.68)ng/ml,P<0.001],正常妊娠妇女组明显低于正常育龄妇女组[(22.43±5.68)ng/ml、(36.46±13.34)ng/ml,P<0.001],差异具有统计学意义;GDM 组的脂联素水平低于正常妊娠妇女组[(5 491.71±2 986.00)ns/ml、(6 692.34±2 583.51)ng/ml,P=O.029],差异有统计学意义,正常妊娠妇女组明显低于正常育龄妇女组[(6 692.34±2 583.51)ng/ml、(11 076.82±3 694.75)ng/ml,P<0.1301],差异具有统计学意义;GDM组抵抗素水平与正常妊娠妇女组比较差异没有统计学意义.在妊娠糖尿病患者组,HOMA-IR与瘦素(r=0.352,P=0.005)正相关,与内肥素(,=-0.255,P=0.046)呈负相关.结论:妊娠糖尿病患者瘦素水平升高,内肥素和脂联素水平降低,瘦素和内肥素与胰岛素抵抗有关,瘦素和内肥素参与了妊娠糖尿病胰岛素抵抗的发生发展;脂联素和抵抗素与胰岛素抵抗不具有相关性,脂联素和抵抗素可能与妊娠糖尿病胰岛素抵抗的发生无关.     

Leptin基因甲基化与糖尿病的相关性研究

目的 探讨瘦素基因启动子区甲基化及蛋白表达与糖调节受损(impaired glucose regulation,IGR)以及2型糖尿病(type 2 diabetes mellitus,T2DM)的相关性.方法 采用甲基化特异性PCR对不同血糖水平的个体进行Leptin基因启动子区甲基化检测.用双抗体夹心ABC-酶联免疫吸附法检测血液标本中的瘦素蛋白表达量.结果 与正常对照组(59.2％)相比,T2DM和IGR组Leptin基因的甲基化率偏低(分别为31.5％和43.6％),差异具有统计学意义(x2分别为22.499,5.109,P值均＜0.05).T2DM与IGR组相比甲基化率偏低(x2=3.962,P＜0.05),差异具有统计学意义.患者的瘦素含量相对于正常人均偏高,但仅T2DM组与正常人差异具有统计学意义(q=6.81,P＜0.01).直线回归分析提示,瘦素含量随DNA甲基化程度的降低有增高的趋势,两者呈显著负相关(r=-0.95,P＜0.01).结论 Leptin基因启动子区甲基化与瘦素代谢紊乱可能参与糖尿病的发生和发展.检测IGR和T2DM患者Leptin基因启动子区的甲基化状态和基因蛋白表达,对于早期干预、延缓病程具有一定的参考价值.     

2型糖尿病患者血清抵抗素的检测及其与胰岛素抵抗的关系

目的 探讨检测血清抵抗素水平用于2型糖尿病诊断的意义,并分析其与胰岛素抵抗的关系. 方法 随机收集2型糖尿病患者117例、健康对照组109例,测定其空腹血糖、空腹胰岛素和抵抗素水平.比较上述指标在糖尿病患者和健康对照人群之间的差异.分析抵抗素用于糖尿病诊断的灵敏度、特异度、正确率和ROC曲线下面积.应用Pearson直线相关分析计算抵抗素与胰岛素抵抗指数的相关性. 结果 2型糖尿病患者的血清抵抗素、空腹血糖、空腹胰岛素及胰岛素抵抗指数均显著高于健康对照组(P<0.01).抵抗素用于糖尿病诊断的灵敏度为70.09%、特异度为64.22%、正确率为67.30%、ROC曲线下面积为0.695,诊断试验的准确度为中等.糖尿病患者的血清抵抗素水平与其胰岛素抵抗指数呈显著正相关(r=0.803,P<0.01). 结论 2型糖尿病的发生可能与抵抗素水平增高有关.检测血清抵抗素可用于糖尿病的辅助诊断,并可作为评价胰岛素抵抗程度的一种新的敏感指标.     

内脂素、抵抗素在妊娠期糖尿病发病中的作用

目的探讨新近发现的两种脂肪细胞因子——内脂素和抵抗素,与胰岛素抵抗的关系及其在妊娠期糖尿病(GDM)发病中的作用。方法采用病例对照的研究方法,通过检测40例GDM孕妇和40例正常孕妇的血清内脂素(Visfa-tin)、抵抗素(Resistin)空腹血糖(FPG)和空腹胰岛素(FINS)水平,计算HOMA稳态模型胰岛素抵抗指数(IRI),比较两组胰岛素抵抗程度的差异,并进一步分析内脂素、抵抗素与胰岛素抵抗之间的关系及其在GDM发生过程中所起的作用。结果 (1)GDM组的血清内脂素、抵抗素、空腹血糖(FPG)、空腹胰岛素(FINS)和胰岛素抵抗指数(IRI)均明显高于对照组(P<0.01)。(2)相关分析表明:GDM孕妇的血清内脂素、抵抗素均与胰岛素抵抗指数(IRI)呈显著正相关(r=0.568,0.618,P=0.000),而内脂素与抵抗素之间亦呈密切正相关(r=0.919,P=0.000)。结论 (1)GDM孕妇的血清内脂素、抵抗素水平较正常孕妇明显增高。(2)内脂素、抵抗素均与胰岛素抵抗呈正相关。(3)血清内脂素、抵抗素水平增高以及二者对胰岛素敏感性调节所产生的综合效应是诱导妊娠期糖尿病发生或促进其发展的重要因素。     

Effects of biosynthetic human proinsulin on plasma lipids in type 2 diabetes mellitus

Summary Plasma cholesterol, triglycerides, HDL₂-cholesterol, and HDL₃-cholesterol were studied in 18 patients with Type 2 diabetes. Prior to entering the clinical trial, the study subjects were in stable control under a fixed mixture of 20% regular and 80% NPH (isophane) biosynthetic human insulin twice daily. The patients were randomized to treatment with either biosynthetic human proinsulin or biosynthetic human NPH insulin (controls) twice daily. Glucose control was kept constant in both groups throughout the study. Of the nine patients treated with proinsulin, eight exhibited a decrease of plasma triglycerides (median decrease by 0.13 mmol/l). In contrast, all nine controls showed a rise (median increase by 0.69 mmol/l) of plasma triglycerides (p<0.001). In keeping with the fall of plasma triglycerides, HDL₂-cholesterol rose in all but one proinsulin-treated patients. Both treatment modalities reduced HDL₃-cholesterol with a median decrease of 0.20 mmol/l (p<0.01) with proinsulin and 0.26 mmol/l with NPH insulin (p<0.05).We conclude that human proinsulin is able to reduce plasma triglycerides and to increase HDL₂-cholesterol in the majority of patients with Type 2 diabetes and thus appears to alter favourably risk factors for coronary heart disease.Abbreviations HDL High density lipoproteins - NPH insulin Neutral Protamine Hagedorn (isophane) insulin     

2型糖尿病患者的肺弥散功能检测分析(英)

目的：检测2型糖尿病患者的肺通气和弥散功能，探讨肺脏是否为糖尿病慢性病变的靶器官。方法： 对107名2型糖尿病患者行肺通气及弥散功能检测，并与61名年龄、性别匹配的健康者比较。糖尿病患者需行糖化血红蛋白（HbA1c）、尿白蛋白排泄率（AER）检测、眼底检查以及神经传导速度检查，以评价血糖控制水平以及糖尿病微血管病变状况。结果： 2型糖尿病组肺通气功能与正常对照组相比，无显著差异。2型糖尿病组一氧化碳弥散量（DLCO）及单位肺泡容积的一氧化碳弥散量（DLCO/VA）较对照组明显降低（P<0.05）。DLCO、DLCO/VA与微血管病变积分呈负相关（r分别为-0.291、 -0.324，P<0.01）。此外，DLCO/VA还与年龄、病程呈负相关（r分别为-0.269、-0.236，P<0.05）。结论： 2型糖尿病患者虽然肺通气功能基本正常，但有弥散功能受损，提示肺脏可能也是糖尿病慢性病变的靶器官之一。     

Plasma adiponectin and insulin resistance in Korean type 2 diabetes mellitus

Insulin resistance, which implies impairment of insulin signaling in the target tissues, is a common cause of type 2 diabetes. Adipose tissue plays an important role in insulin resistance through the dysregulated production and secretion of adipose-derived proteins, including tumor necrosis factor-alpha, plasminogen activator inhibitor-1, leptin, resistin, angiotensinogen, and adiponectin. Adiponectin was estimated to be a protective adipocytokine against atherosclerosis, and also to have an anti-inflammatory effect. In this study, the relationship between fasting plasma adiponectin concentration and adiposity, body composition, insulin sensitivity (ITT, HOMAIR, QUICK), lipid profile, fasting insulin concentration were examined in Korean type 2 diabetes. The difference in the adiponectin concentrations was also examined in diabetic and non-diabetic subjects, with adjustment for gender, age and body mass index. 102 type 2 diabetics and 50 controls were examined. After a 12-h overnight fast, all subjects underwent a 75 gram oral glucose tolerance test. Baseline blood samples were drawn for the determinations of fasting plasma glucose, insulin, adiponectin, total cholesterol, triglyceride, LDL-cholesterol, and HDL-cholesterol. The body composition was estimated using a bioelectric impedance analyzer (Inbody 2.0). The insulin sensitivity was estimated using the insulin tolerance test (ITT), HOMAIR and QUICK methods. In the diabetic group, the fasting adiponectin concentrations were significantly lower in men than in women. They were negatively correlated with BMI (r=-0.453), hip circumference (r=-0.341), fasting glucose concentrations (r=-0.277) and HOMAIR (r= -0.233). In addition, they were positively correlated with systolic blood pressure (r=0.321) and HDL-cholesterol (r= 0.291). The systolic blood pressure and HDL-cholesterol were found to be independent variables, from a multiple logistic regression analysis, which influenced the adiponectin concentration. Compared with the non-diabetic group, the adiponectin concentrations were significantly lower in the diabetic group, with the exception of obese males. In conclusion, the plasma adiponectin concentrations were closely related to the insulin resistance parameters in Korean type 2 diabetic patients.