老年2型糖尿病患者血清脂联素、瘦素水平与糖脂代谢异常相关性临床研究

【目的】探讨血清脂联素、瘦素在老年2型糖尿病和2型糖尿病伴肥胖患者的水平及其与糖脂代谢异常的相关性。【方法】对140例居住在天津的被检者采集病史、进行体格检查并留取血清测定其血糖、胰岛素、瘦素、血脂和脂联素的水平。【结果】老年2型糖尿病合并肥胖组与老年2型糖尿病组之间的血浆脂联素水平存在显著性差异,且二者均低于对照组,其瘦素水平显著高于非老年对照组;老年与非老年对照组之间的血浆脂联素水平无显著性差异。简单相关分析提示脂联素与腰围、空腹和餐后1 h和2 h血糖、胰岛素抵抗指数、瘦素负相关,与高密度脂蛋白正相关;采用逐步回归法分析,校正其它参数,腰围、瘦素和空腹血糖为影响脂联素水平的独立因素。【结论】老年2型糖尿病患者的血浆脂联素水平降低,在肥胖、2型糖尿病、瘦素、胰岛素和脂联素之间可能存在互动的相关性。

Relationship between adiponectin, leptin and abnormality of glucose, lipids metabolism in aged type 2 diabetes patients

[Objective] To investigate the level of human serum adiponectin and the relationship between serum adiponectin and leptin as wen as glucose, lipids profiles in aged type 2 diabetes with or without obesity. [Methods] A total of 140 patients resident in Tinjin were recruited. An data were taken at the same time by taking history and physical examination followed by collection of fasting blood sample for analysis. [Results] The levels of the serum adiponectin showed significant difference between the aged type 2 diabetes and the normal control. As to the aged type 2 diabetes with obese, the level of adiponectin were lower than that in control. The level of adiponectin showed no difference between the aged and the young. Adiponectin level was inverted correlation with waist size （WS）, fasting and 1 h, 2 h postprandial glucose, glucose intolerance in OGTT, insulin resistance index （HOMA-IR）, leptin. The adiponectin levels were positively correlated with HDL. In step regression analysis, WS, leptin and fasting glucose remained significantly related with adiponectin concentrations after adjustment for all the other variables in this study. [Conclusions] The adiponectin level in the aged people with type 2 diabetes are lower than nondiabetic. Our study shows that there is a mutual modulatory mechanism among the obesity, type 2 diabetes, leptin, insulin and adiponectin.