血清可溶性肿瘤坏死因子受体与胰岛素抵抗的关系

目的　了解血清可溶性肿瘤坏死因子受体 (STNFR) 1,2与胰岛素抵抗 (IR)的关系。方法　测定 43名男性和 41名绝经期前女性的STNFR1,2。以稳态模型 (HomaModel)公式评估IR。结果　肥胖男、女组STNFR1与非肥胖男、女组相近 ,而其STNFR2高于非肥胖男、女组 ,差异有显著性 (P <0 .0 5 )。所有男性STNFR1和STNFR2水平高于女性 (P <0 .0 1)。所有对象相关分析示STNFR2与臀腰比 (WHR)、空腹血糖、体重指数 (BMI)、HomaIR、空腹胰岛素正相关。STNFR1与上述指标无相关性。在男性中 ,STNFR2与瘦素正相关 (r =0 .34 ,P <0 .0 5 ) ,调整BMI、WHR影响后 ,STNFR2仍与瘦素正相关 (r=0 .30 ,P <0 .0 5 )。逐步回归分析示WHR和STNFR2对HomaIR的影响达 41.3%。结论　STNFR2与IR相关 ,在人类TNF系统对IR的影响可能主要通过TNFR2起作用。

The relationship between soluble tumor necrosis factor receptor and insulin resistance

Objective To study the relationship between soluble tumor necrosis factor receptor (STNFR) 1,2 and insulin resistance (IR). Methods STNFR1 and STNFR2 were measured by ELISA in 43 men and 41 premenopausal women. IR was assessed by Homa Model. Results Obese men and women showed higher levels of STNFR2 than nonobese men and women (P<0.05). No significant difference of STNFR1 level was shown between obese and nonobese. Compared to women, all men showed higher levels of STNFR1 and STNFR2 (P<0.01). Obese men had higher levels of STNFR2 than obese women (P<0.05). In all subjects STNFR2 correlated with waist hip ratio (WHR) (r=0.45, P<0.01), fasting plasma insulin (r=0.40, P<0.01), body mass index (BMI) (r=0.34, P<0.05), Homa IR (r=0.32, P<0.05) and fasting insulin (r=0.33, P<0.05). STNFR1 did not associated with any of these variables. In all men STNFR2 positively correlated with leptin (r=0.34, P<0.05),and after adjustment by BMI and WHR, the relationship between them remained significantly (r=0.30, P<0.05). In a multiple stepwise regression analysis, WHR (r=0.29, P<0.01) and STNFR2 (r=0.21, P<0.05) independently influence the value of Homa IR at 41.3%. Conclusion The results show that there is a posistive relationship between STNFR2 and IR, which suggests that the action of TNF system on IR may be through TNFR2.