2型糖尿病患者胰岛素抵抗与脂联素、瘦素关系的探讨

目的:通过对2型糖尿病患者血清脂联素、瘦素水平检测及二者之间的比值分析,探讨DM2胰岛素抵抗发生的机理,为临床诊断治疗提供依据。方法:用酶联免疫分析和放射免疫分析对87例DM2,25例DM1患者和30例正常对照者及52例DM2经一年治疗前后脂联素、瘦素水平进行检测分析。结果:DM2患者脂联素水平明显低于DM1和正常对照组(P<0.01);瘦素水平DM1、DM2均高于正常对照组,DM2明显高于DM1(P<0.01);脂联素/瘦素的比值DM1>1(1.183),DM2<1(0.211),DM1与DM2比值比较有显著性差异(P<0.001);52例DM2治疗前后比较,脂联素、瘦素及二者比值有显著差异(P<0.01),脂联素与瘦素比较呈负相关。结论:2型糖尿病胰岛素抵抗的发生与脂联素、瘦素密切相关,二者的比值变化对糖尿病分型具有重要意义。

Exploration on the Relationship Between Insulin Resistance and Adiponectin,Leptin in Patients with Diabetes Mellitus Type 2 (DM2)

Objective To explore the relationship between development of insulin resistance and the change of adioponectin/leptin ratio in patients with DM2. Methods Serum adiponectin (with ELISA) and leptin (with RIA) levels were measured in 87 patients with DM2, 25 patients with DM1 and 30 controls. Besides, the levels were measured in another 52 patients with DM2 both before and after one-year treatment. Results The serum levels of adiponectin in patients with DM2 were significantly lower than those in patients with DM1 and controls (P<0.01). The serum levels of leptin in both the patients with DM1 and DM2 were significantly higher than those in controls with levels in DM2 patients much higher (DM2 vs DM1, P<0.01). The adiponectin/leptin ratio in DM2 patients was significantly smaller than that in DM1 patients (0.211 vs 1.183, P<0.001). In the 52 DM2 patients undergoing one year treatment, the adiponectin levels increased and the leptin levels dropped significantly with the adiponectin/leptin ratio greatly increased (vs before treatment, P<0.05~0.01). Conclusion Increased insulin resistance in DM2 patients was shown to be in parallel with decreased serum levels of adiponectin and low adiponectin/leptin ratio (usually much lower than 1).