强化控制血糖、血压、血脂对2型糖尿病患者肥胖抑制素水平的影响及其与脂代谢的相关性

目的 观察强化控制血糖、血压、血脂对2型糖尿病患者肥胖抑制素水平的影响及其与脂代谢的相关性.方法 将72例2型糖尿病患者根据治疗方法不同分为4组:A组25例,强化血糖、血压控制；B组12例,A组基础上加用强化血脂治疗；C组20例和D组15例,在B组基础上分别加用维生素E和复方丹参滴丸治疗.结果 A组空腹血浆肥胖抑制素水平低于其他3组,差异有统计学意义(P＜0.01)；空腹血浆肥胖抑制素浓度与体质量指数(BMI)、腰臀比(WHR)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FIN)和胰岛素抵抗指数(HOMA-IR)呈负相关(P均＜0.05),与HDL-C呈正相关(P＜0.05)；逐步校正年龄、性别、BMI、WHR、血糖和血压后,较高水平的空腹血浆肥胖抑制素浓度与强化控制血脂相关(P＜0.01).结论 强化控制血脂较未强化控制血脂的2型糖尿病患者空腹血浆肥胖抑制素水平升高,肥胖抑制素可能与脂代谢相关.

Strengthening control of blood glucose, blood pressure, and blood lipids in type 2 diabetes mellitus patients: influence on obestatin level and relation with lipid metabolism

Objective To observe the influence of intensive control of blood glucose,blood pressure and blood lipid on fasting plasma obestatin level in type 2 diabetes mellitus(T2DM) patients and its correlation with lipid metabolism.Methods Seventy-two T2DM patients were assigned to four groups according to different treatments.Group A(n=25) received blood glucose(BG) and blood pressure(BP)controlling;group B(n=12) received BG,BP and blood lipid(BL) controlling;group C(n=20) received BG,BP,and BL controlling plus vitamin E administration;and group D(n=15) received BG,BP,BL controlling and compound Danshen dripping pill administration.Results Fasting obestatin level of group A was significantly lower than those in the other three groups(P<0.01).Fasting obestatin level was negatively correlated with body mass index(BMI),HbAlc,waist to hip ratio(WHR),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),fasting insulin(FIN) and hemeostasis model assessment of insulin resistance(HOMA-IR)(P<0.05),and was positively correlated with high-density lipoprotein cholesterol(HDL-C)(P<0.05).After adjusting age,sex,BMI,WHR,blood glucose,and blood pressure,high level fasting obestatin was correlated with intensified control of blood lipid(P<0.01).Conclusion The fasting obestatin level is increased in T2DM patients receiving BL control compared with those do not receive,and obestatin level might be associated with lipid metabolism.