血清抵抗素、超敏C反应蛋白在肥胖、2型糖尿病患者中的变化

目的观察肥胖、2型糖尿病患者的血清抵抗素及超敏C反应蛋白（hs-CRP）水平及其与胰岛素抵抗的关系。方法对照组（NC）28例、糖尿病非肥胖组（DM1）30例、糖尿病肥胖组（DM2）30例。酶联免疫测定法检测空腹血清抵抗素,免疫比浊法测定血清hs-CRP。计算胰岛素分泌功能指数（HOMA2-%B）、胰岛素敏感性指数（HOMA2-%S）以及胰岛素抵抗指数（HOMA2-IR）。结果DM1组和DM2组的hs-CRP、抵抗素均高于NC组（P〈0.05）,且DM2组高于DM1组（P〈0.01）。抵抗素与体质量指数（BMI）、hs-CRP、HOMA2-%B、HOMA2-IR存在相关性（r分别为-0.252,0.563,0.225,0.667,P值均〈0.05）。hs-CRP与腰围、BMI、HOMA2-IR存在相关性（r分别为0.773,0.594,0.662,P值均〈0.05）,与抵抗素存在相关性（r为0.563,P〈0.05）。校正年龄、血糖之后,hs-CRP仍与腰围、BMI、HOMA2-IR、抵抗素独立相关。结论抵抗素水平在肥胖、2型糖尿病中升高,并与BMI、HOMA2-%B、HOMA2-%IR、hs-CRP均呈显著相关,可能为联系肥胖与胰岛素抵抗的重要因素。抵抗素、炎性因子可能在肥胖、2型糖尿病的发病中起重要作用。

Changes of Serum Resistin and High-Sensitivity C-Reactive Protein in Patients with Obesity and Type 2 Diabetes Mellitus

Objective To study serum resistin and high-sensitivity C-reactive protein （hs-CRP） level, and their relationship with insulin resistance in patients with obesity and type 2 diabetes mellitus. Methods The subjects were divided into 3 groups： the normal group （NC）, 28 cases; the type 2 diabetes group with normal weight （DM1）, 30 cases; and the obese group with diabetes （DM2）, 30 cases. The serum resistin was measured by enzyme immunoassay and hs-CRP was detected by unoturbidimetry. Homeostasis model assessment β-cell index （HOMA2-%B）, insulin resistance index （HOMA2-IR）, and insulin sensitivity index （HOMA2-%S） were calculated. Results The serum resistin and hs-CRP levels in the DM1 group were higher than those in the NC group （P〈0.05） ; the levels in the DM2 were higher than those in either the NC group or the DM1 group （P〈0.01）. Pearsonanalysis showed that the serum resistin was correlated with BMI, hs-CRP, HOMA2-%B, and HOMA2-IR （r=-0. 252, 0. 563, 0. 225, 0. 667, respectively, P〈0.05 for all）, and that hs-CRP was correlated with WC, BMI, HOMA2-IR （r= 0. 773, 0. 594, 0. 662, respectively, P〈0.01 for all） ,and resistin （r=0. 563, P〈0.05）. After adjusting age and plasma glucose, hs-CRP was still associated with WC, BMI, HOMA2-IR, and resistin. Oonclusion The increase of serum resistin level in patients with obesity and type 2 diabetes and its correlation with BMI, HOMA2-%B, HOMA2-%IR, and hs-CRP suggest that resistin may serve as an important link between obesity and insulin resistance. Resistin and hs-CRP play an important role in patients with obesity and diabetes