不同病程2型糖尿病病人血清RBP4、NEFA、Hcy水平与胰岛素抵抗的相关性分析

目的探讨不同病程2型糖尿病（T2DM）病人血清视黄醇结合蛋白4（RBP4）、游离脂肪酸（NEFA）及同型半胱氨酸（Hcy）水平与胰岛素抵抗（IR）的相关性。方法选取T2DM病人145例，其中病程 < 6个月57例（A组），病程6个月至5年64例（B组），病程>5年24例（C组），另选择同期非糖尿病病人50例作为对照（D组）。所有研究对象均测量身高、体质量、腹围、腰围、收缩压，并检测病人空腹血糖、空腹胰岛素、高密度脂蛋白、低密度脂蛋白、总胆固醇、三酰甘油、糖化血红蛋白、RBP4、NEFA及Hcy水平，计算胰岛素抵抗指数（HOMA-IR）、腰臀比及体质量指数，并分析不同病程T2DM病人血清RBP、NEFA、Hcy水平与IR的相关性。结果不同病程T2DM病人收缩压、腰臀比、体质量指数、空腹血糖、空腹胰岛素、三酰甘油、总胆固醇、高密度脂蛋白、低密度脂蛋白、糖化血红蛋白、HOMA-IR间差异均有统计学意义（P < 0.05~P < 0.01），且不同病程T2DM病人上述指标与D组差异均有统计学意义（P < 0.05~P < 0.01）。不同病程T2DM病人RBP4、NEFA和Hcy比较差异均有统计学意义（P < 0.01），且均明显高于D组（P < 0.01）。T2DM病人血清RBP4（r=0.503，P < 0.01）、NEFA（r=0.877，P < 0.01）、Hcy（r=0.842，P < 0.05）与HOMA-IR均呈相关关系。结论随T2DM病人病程增加，IR更加显著，这可能与病人血清RBP4、NEFA、Hcy水平上升有关。

Correlation between insulin resistance and serum levels of RBP4, NEFA and Hcy in patients with different courses of type 2 diabetes mellitus

ObjectiveTo investigate the relationship between the insulin resistance(IR) and serum levels of retinol binding protein 4(RBP4), nonestesterified fatty acid(NEFA) and homocysteine(Hcy) in patients with different courses of type 2 diabetes mellitus(T2DM).MethodsA total of 145 patients with T2DM were divided into the group A(disease duration < 6 months), group B(disease duration of 6 months to 5 years) and group C(disease duration >5 years), and 50 patients without diabetes were set as the group D.The height, body mass, waist circumference, systolic blood pressure in four groups were measured, the levels of fasting blood glucose, fasting insulin, high-density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), total cholesterol, three acyl glycerin, glycosylated hemoglobin, RBP4, NEFA and Hcy in four groups were detected, the insulin resistance index(HOMA IR), waist hip ratio, body mass index in four groups were calculated, and the correlation of IR with serum levels of RBP, NEFA and Hcy in patients with different courses of T2DM were analyzed.ResultsThe differences of the levels of SBP, WHR, BMI, FPG, FINS, TG, CHO, HDL, LDL, HbA1c and HOMA-IR among group A, group B and group C were statistically significant(P < 0.05~P < 0.01), and the differences of above indexes between A, B, C groups and D group were statistically significant(P < 0.05~P < 0.01).The differences of the serum levels of RBP4, NEFA and Hcy among A, B and C groups were ere statistically significant(P < 0.01), and which were significantly higher than those in group D(P < 0.01).The serum levels of RBP4, NEFA and Hcy were positively correlated with HOMA-IR and the correlation coefficients of those were 0.503, 0.877, and 0.842, respectively(P < 0.05 to P < 0.01).ConclusionsWith the lengthening of the disease course of T2DM, the IR is more significant, which may be related to the increasing of serum levels of RBP4, NEFA and Hcy.