合并2型糖尿病的急性脑梗死患者血清脂联素、肿瘤坏死因子与胰岛素抵抗的关系

目的：分析合并2型糖尿病的急性脑梗死患者血清脂联素、TNF—a水平变化及其与胰岛素抵抗（IR）、肥胖的相关性。方法：选择合并2型糖尿病的急性脑梗死患者92例，分为肥胖组（体重指数BMI≥25kg／m2）42例、非肥胖组（BMI〈25奴／m2）50例、正常对照组40例，测定血清脂联素、TNF—a、体重、身高、血脂、空腹血糖（fPG）、餐后2h血糖（2hPG）、空腹胰岛素（fINS）、餐后2h胰岛素（2hINS）、计算胰岛素抵抗指数（HOMA—IR），做相关性分析。结果：肥胖组脂联素低于非肥胖组（P〈0．05）及正常对照组（P〈0．01），非肥胖组又低于正常对照组（P〈0．05）。而肥胖组TNF-a高于非肥胖组（P〈0．05）及正常对照组（P〈0．01），非肥胖组又高于正常对照组（P〈0．05）。脂联素与BMI、HOMA-IR呈负相关TNF-a与BMI、HOMA-IR呈正相关。结论：脂联素、TNF—a与IR密切相关，参与了糖脂代谢紊乱。

Study on the Relationship Between Changes of Serum Adiponeefin Tumor Necrosis Factor Levels and Insulin Resistance in Acute Ischemic Stroke Patients with Type 2 Diabetes Mellitus

Objective： To study the relationship between changes of serum adiponeefin, tumor necrosis factor levels （ TNF-a ） and insulin resistance（IR）, obesity parameters in acute ischemic stroke patients with type 2 diabetes mellitus. Methods： Serum adiponeefin（with RIA）, TNF-a （with ELISA）levels as well as fPG, 2hPG, fasting insulin, 2h insulin, lipid profile were measured in 42 obese acute ischemic stroke patient with DM2 （BMI〉25）, 50 acute ischemic stroke patients with non-obese DM2 （BMI〈25） and 42 acute isehemic stroke. Results： The level of adiponeefin in obese group were significantly lower than those in the other groups（P〈0. 05 ＆ P〈0. 01）, while TNF-a levels in non-obese group were significantly lower than those in controls（P〈0. 01）. The levels of in Obese group were significantly higher than those in the other groups（P〈0. 05 ＆ P〈0. 01）, while the levels in non-obese group were signifi- cantly higher than the levels in controls（P〈0. 01）. The adiponeefin levels were negatively correlated with insulin resistance（HOMA-IR）and BMI, while the cytokines levels were positively correlated with HOMA-IR and BMI. Conclusion： Adiponeefin and TNF-a are closely related with insulin resistance, and take parts in development of the abnormal glucose metabolism.