脂肪细胞因子与胰岛素抵抗及肥胖关系

目的 分析吉林延边地区朝鲜族和汉族居民脂肪细胞因子与胰岛素抵抗（IR）和肥胖的关系。方法 于2009年8月—2011年8月采用简单随机和整群抽样方法对在延边农村地区抽取的6 918名朝鲜族和汉族常住居民进行问卷调查和体格检查。结果 调整年龄及性别协方差分析结果显示，朝鲜族居民脂联素水平低于汉族居民，而瘦素、肿瘤坏死因子-α（TNF-α）、稳态胰岛素评价指数（HOMA-IR）、腰围（WC）及体质指数（BMI）水平均高于汉族居民（均P<0.001）；调整年龄、性别及民族偏相关分析结果显示，HOMA-IR、WC及BMI与脂联素均呈负相关（r=-0.080、-0.237、-0.280），与瘦素（r=0.103、0.405、0.520）及TNF-α（r=0.192、0.898、0.692）均呈正相关（均P<0.001）；多元线性回归分析结果显示，HOMA-IR、WC及BMI水平升高会使脂联素水平降低，使瘦素和TNF-α水平升高。结论 朝鲜族和汉族居民脂联素、瘦素及TNF-α分布存在差异，HOMA-IR、WC及BMI对脂联素、瘦素及TNF-α均有影响，且肥胖的影响大于HOMA-IR。

Association of adipocytokines with insulin resistance and obesity

Objective To analyze the association of adipocytokines with insulin resistance(IR)and obesity.Methods Using simple cluster random sampling method,6 918 Korean and Han people residing in rural area of Yanbian city were selected and investigated with a questionnaire survey and physical examination.Results The level of adiponctin was higher in Han-Chinese than that in Korean-Chinese,and the levels of leptin (only for males),tumor necrosis factor-alpha(TNF-α),homeostasis model assessment-insulin resistance(HOMA-IR),waist circumference(WC)and body mass index(BMI)were higher in Korean-Chinese than those in Han-Chinese for both sexes (all P<0.001).The Results of partial correlation analysis showed that adiponectin was inversely related with HOMA-IR,WC and BMI,with the r values of-0.080,-0.238,and-0.280 (P<0.001 for all)and leptin (r=0.103,0.404 and 0.520;P<0.001)and TNF-α (r=0.192,0.898 and 0.692;P<0.001)were positively related with HOMA-IR,WC and BMI after adjustment for age,sex and race.The Results of multivariate regression analysis showed significant linear correlations between adiponectin (β'=-0.036,-0.062 and-0.224),leptin (β'=0.027,0.044 and 0.485),and TNF-α (β'=0.031,0.852 and 0.067)and HOMA-IR,WC,and BMI.Conclusion There are significant differences in the distributions of adiponectin,leptin and TNF-α between different ethnic group.HOMA-IR,WC and BMI have significant effects on adiponectin,leptin and TNF-α,and the affection of obesity is stronger than that of HOMA-IR.