2型糖尿病患者体脂含量及分布与血清内脂素水平的相关研究

目的探讨2型糖尿病（T2DM）患者体脂含量及分布与血清内脂素水平的关系。方法选择2012年10月-2013年9月收治的119例T2DM患者作为研究对象。测定腹内脂肪面积（VFA）、腹部皮下脂肪面积（SFA）、血清内脂素（visfatin）、游离脂肪酸（FFA）、空腹胰岛素（FINS）和相关的临床指标,计算胰岛素抵抗指数（HOMA-IR）和腰臀比（WHR）。根据VFA的四分位数法分为A、B、C和D组。比较4组间的血清内脂素水平,并对VFA与内脂素、FFA等指标行相关性分析。结果C和D组的内脂素、FFA、FINS水平显著高于A和B组,随着VFA增加,内脂素水平也显著增加。内脂素与BMI、WHR、FFA、HOMA-IR、FINS、TG、VFA、SFA均存在一定的相关关系（r分别为0.426、0.501、0.704、0.477、0.465、0.211、0.508、0.185,P〈0.05）,在校正SFA、BMI、WHR、FFA、HOMA-IR、FINS、TG的影响后,偏相关系数（r＇）为0.291（P﹤0.01）。多元线性逐步回归分析以内脂素为因变量,以BMI、WHR、FFA、HOMA-IR、FINS、TG、VFA、SFA为自变量,显示VFA、FFA、WHR是内脂素的独立相关因素。结论 2型糖尿病患者体脂含量和分布影响血清内脂素水平,内脂素与VFA呈显著正相关（r=0.508,P﹤0.01）。

The relationship of visfatin with body fat content and fat distribution in type 2 diabetes

Objective To study the relationship of visfatin with body fat content and fat distribution in type 2 diabetes. Methods We collected the clinical data,abdominal visceral fat area（ VFA）,abdominal subcutaneous fat area（ SFA）,free fatty acid（ FFA）,FINS and related clinical variables of type 2 diabetic inpatients at our hospital. And HOMA-IR,WHR were calculated. According to the puartile of VFA,the subjects were divided into A,B,C and D groups. And their profiles were compared with regards to the level of visfatin. Their relative intensities of VFA and visfatin were analyzed. Results Visfatin,FFA and FINS of group C and D were larger than that of group A and B. With the rising level of VFA,the level of visfatin increased. There are some correlation between visfatin and BMI,WHR,FFA,HOMA-IR,FIns,TG,VFA,SFA（ r = 0. 426 0. 501,0. 704,0. 477,0. 465,0. 211,0. 508,0. 185,P〈0. 05）. After SFA,BMI,WHR,FFA,HOMA-IR,FIns and TG adjusting,partial correlation coefficient of 0. 291（ P〈0. 01）. Multiple regression analysis showed that VFA,FFA and WHR were independent related factors for influencing the serum visfatin level. Conclusion Serum level of visfatin is affected by body fat content or fat distribution in type 2 diabetes. Visfatin has a positive relationship with VFA.