脂联素与肝源性糖尿病的相关研究

目的检测肝源性糖尿病患者血清脂联素浓度，探讨脂联素与肝源性糖尿病的关系。方法筛选住院的肝源性糖尿病患者30例，同期门诊确诊的初发单纯2型糖尿病29例，查体正常人员（正常对照组）31例为研究对象，分别检测血清脂联素、空腹血糖（FBG）、空腹胰岛素（FINS）、：丙氨酸转移酶（ALT）、天冬氨酸转移酶（AST）、总胆红素（TBLL）和白蛋白（ALB）水平、并计算胰岛素敏感指数（ISI）和胰岛素抵抗指数（HOMA—IR）。结果肝源性糖尿病组和初发2型糖尿病组脂联素水平明显低于正常对照组（P〈0．01）；肝源性糖尿病组脂联素水平明显高于初发2型糖尿病组（P〈0．05）。肝源性糖尿病组和初发2型糖尿病组ISI水平明显低于正常对照组（P〈0．01）；肝源性糖尿病组FBG、FINS、HOMA—IR和初发2型糖尿病组FBG、HOMA-IR水平明显高于正常对照组（P〉0．01）；肝源性糖尿病组FINS水平明显高于初发2型糖尿病组（P〉0．05），而FBG、ISI水平明显低于初发2型糖尿病组（P〉0．05）。脂联素与FBG、HOMA-IR呈显著负相关；与ISI呈显著正相关；与肝功能指标无相关性。结论肝源性糖尿病患者存在明显胰岛素抵抗且脂联素代谢发生异常，两者可能共同影响肝源性糖尿病的发生和发展。

Measurement of serum adiponectin level in hepatogen diabetes patients

Objective To detect the serum levels adiponectin and evaluate its clinical significance in hepatic diabetes.Methods 30 hepatogenous diabetes(hepatogenous diabetes group) ,29 simple type 2 diabetes without any complications (simple type 2 diabeteswithout any complications group)and 31 normal were enrolled into this study (control group).Blood adiponectin,fasting blood glucose (FBG) ,fasting insulins (FINS) ,alanine aminotransferase (ALT) ,aspartate transferase (AST) ,total bilirubin (TBIL) and albumin (ALB),insulin sensitivity index(ISI) and insulin resistance index(HOMA-IR) were measured.The differences and the relationship of the laboratory results were compared.Results Compared with the normal group,serum adiponectin levels and ISI levels were significantly lower in other two groups (P ＜ 0.01,) while the adiponectin levels were higher in hepatogenous diabetes group than in simple type 2 diabetes group(P ＜ 0.05).The FBG and FINS and HOMA-IR levels of hepatogenous diabetes group and the FBG and HOMA-IR levels of simple type 2 diabetes group were higher significantly than that of normal group.(P ＜ 0.01),the levels of FINS of hepatogenous diabetes group were higher significantly than that of simple diabetes group (P ＜ 0.05) while the levels of FBG and ISI were lower than that of simple type 2 diabetes group(P ＜ 0.05).Adiponectin levels were negatively correlated with FBG and HOMA-IR,positively correlation with ISI and without any correlation with liver functions.Conclusion There were significant insulin resistance and abnormal metabolism of adiponectin in hepatogenous diabetes,probabily the two factors influence the occurrence and development of hepatogenous diabetes in common.