2型糖尿病患者血清抵抗素水平降低

目的　探讨人血清抵抗素水平与肥胖、胰岛素抵抗和 2型糖尿病 (DM)的关系。方法　5 1例新诊断的 2型DM患者和 5 2名年龄、性别匹配的糖耐量正常的对照者 ,采用酶联免疫分析法检测其空腹及口服 75 g葡萄糖后 2h的血清抵抗素、瘦素和真胰岛素水平 ,同时观测血糖、血压、身高、体重、腰 /臀围 ,计算体重指数 (BMI)、腰臀比值 (WHR)和定量胰岛素敏感指数 (QUICKI)。结果　 2型DM组的WHR、真胰岛素水平均高于对照组 (P <0 0 1) ,但抵抗素水平与对照组比较 ,无论空腹( 2 3ng/ml± 15ng/ml与 30ng/ml± 18ng/ml,P <0 0 5 )还是糖负荷后 2h( 2 2ng/ml± 11ng/ml与 31ng/ml± 15ng/ml,P <0 0 1)均明显低于对照组。瘦素水平两组间未见统计学差异 (P >0 0 5 )。糖负荷前后比较 ,两组的 2h胰岛素水平均显著增加 (P <0 0 0 1) ,但抵抗素的差异无显著性 (P >0 0 5 )。相关分析显示空腹抵抗素水平与性别、BMI和WHR、血压以及瘦素水平等均不相关 (P >0 0 5 ) ,但与空腹血糖呈负相关 (r =- 0 2 1,P <0 0 5 ) ,与QUICKI敏感指数 (r =0 30 ,P <0 0 1)正相关。结论　 2型DM患者血清抵抗素水平降低而不是升高 ,且与肥胖关系不明显 ,因而抵抗素可能并不是肥胖和 2型DM的主要连接点

Reduced resistin levels in patients with type 2 diabetes mellitus

OBJECTIVE: To measure the serum resistin level of patients with type 2 diabetes mellitus so as to examine whether there exists a relationship between resistin, obesity and diabetes. METHODS: ELISA was used to examine the fasting serum resistin, leptin, and true insulin and those 2-hours after taking 75-g glucose in 51 untreated type 2 diabetic patients, 30 males and 21 females, and 52 sex and age-matched normal control subjects. Blood glucose, blood pressure, height, weight, waist circumstance, hip girth were measured. Body mass index (BMI), waist to hip ratio (WHR), and quantitative insulin sensitivity check index (QUICKI) were calculated. RESULTS: In comparison with the control, the diabetic group had higher waist-to-hip ratio (WHR) and serum insulin levels (P < 0.05), but significantly lower resistin levels both in the fasting status (23 ng/ml +/- 15 ng/ml vs 30 ng/ml +/- 18 ng/ml, P < 0.05) and 2 hours after glucose loading (22 ng/ml +/- 11 ng/ml vs 31 ng/ml +/- 15 ng/ml, P < 0.001). The leptin level was not statistically different between the two groups (P > 0.05). The resistin level 2 hours after glucose loading was not significantly different between these 2 groups. Correlation analysis demonstrated that fasting resistin level was not correlated with sex, BMI, leptin, and blood pressure, but positively correlated with QUICKI (r = 0.30, P < 0.01) and negatively correlated with blood glucose (r = -0.21, P < 0.05). CONCLUSION: The serum resistin level of patients with type 2 diabetes is reduced rather than increased in fasting status and 2 hours after glucose taking. Resistin may not be the major link between obesity and diabetes in human beings. Since human resistin level is positively correlated with insulin sensitivity, the use of term "resistin", originally for its resistance to insulin, may be somewhat premature.