抵抗素与胰岛素抵抗及尿白蛋白排泄率的相关性研究

目的 探讨人类抵抗素水平与2型糖尿病(T2DM)胰岛素抵抗及尿微量白蛋白的相关性.方法 选择T2DM患者220例,其中胰岛素抵抗组(A组)79例,非胰岛素抵抗组(B组)48例,胰岛素抵抗合并尿微量白蛋白尿白蛋白排泄率(UAER) 20～200 μg/min]组(C组)51例,非胰岛素抵抗合并尿微量白蛋白组(D组)42例.另选取健康体检者40例(对照组).采用酶联免疫吸附法(ELISA)测定各组空腹血清抵抗素,同时体检并检测空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)等生化指标.结果 A、B、C、D组血清抵抗素分别为(33.45±1.37)、(23.36±1.47)、(44.45±1.39)、(37.45±1.57) μg/L,均高于对照组的(17.44±1.26) μg/L,差异有统计学意义(P＜0.01)；A组血清抵抗素高于B组,C组血清抵抗素高于D组,差异均有统计学意义(P＜0.01)；C组和D组血清抵抗素均高于A组和B组,差异均有统计学意义(P＜0.01).A组抵抗素与体质指数(BMI)、FPG、HbA1c、FINS呈正相关(r=0.35、0.46、0.37、0.49,P值均＜0.05).C组抵抗素与HbA1c、BMI、收缩压、舒张压呈正相关(r=0.45、0.32、0.37、0.29,P值均＜0.05).结论 血清抵抗素可能参与了胰岛素抵抗及尿微量白蛋白的发生过程,并有可能成为诊断胰岛素抵抗和预测尿微量白蛋白发生的重要指标之一.

Correlation study between resistin and the insulin resistance and the urinary albumin excretion rate

Objective To investigate the correlation between the level of resistin and the insulin resistance (IR) and the incorporation of microamount albuminuria (MA) of type 2 diabetes mellitus (T2DM).Methods Two hundred and twenty T2DM patients and 40 normal subjects (control group) were enrolled in this study.Two hundred and twenty T2DM patients were divided into 4 groups,IR group (group A,79 cases),non-IR group (group B,48 cases),IR complicating MA group (group C,51 cases),non-IR complicating MA group (group D,42 cases).The fasting serum resistin was measured by enzyme-linked immunosorbant assay (ELISA),and the fasting plasma glucose (FPG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS) was also determined.Results The level of fasting serum resistin in group A,B,C and D was higher than that in control group (33.45 ± 1.37),(23.36 ± 1.47),(44.45 ± 1.39),(37.45 ±1.57) μ g/L vs.( 17.44 ± 1.26 ) μ g/L],and there was significant difference among 5 groups (P ＜ 0.01 ).The level of fasting serum resistin in group A was higher than that in group B (P ＜ 0.01 ),and the level of fasting serum resistin in group C was higher than that in group D (P ＜ 0.01 ).The level of fasting serum resistin was both higher in group C and D than that in goup A and B (P＜ 0.01 ).Correlation analysis showed the fasting serum resistin was positively correlated with body mass index(BMI),FPG,HbA1c and FINS in group A(r =0.35,0.46,0.37,0.49,P ＜0.05),and the fasting serum resistin was positively correlated with HbA1c,BMI,systolic blood pressure and diastolic blood pressure in group C(r =0.45,0.32,0.37,0.29,P ＜ 0.05 ).Conclusions Serum resistin may participate in the process of IR and the formation of MA.It may become one of the diagnostic standard of the IR and one of the important index to estimate the MA.