老年糖耐量异常者脂联素水平的改变及其影响因素

目的:探讨老年糖耐量异常者脂联素的改变及其影响因素。方法:对年龄≥60岁的糖耐量正常(NGT)、糖耐量低减(IGT)和2型糖尿病(DM)患者进行体质量、腰臀围、血压、血脂、氧化应激指标和脂联素的检测,以所有检测者脂联素水平的中位数为界限将患者划分为高、低脂联素组。结果:NGT、IGT和DM3组间脂联素水平逐步降低,其中DM组明显低于NGT和IGT组(P<0.01)。低脂联素组与高脂联素组相比较,NGT人数明显减少(7vs18),而DM人数则明显增加(27vs10),空腹血糖(FBS)、口服糖耐量试验(OGTT2h)血糖增高,高密度脂蛋白(HDL)水平降低,差别有统计学意义均(P<0.01)。Logistic多元回归分析显示血糖和血脂为影响脂联素水平变化的独立危险因素。结论:脂联素水平的下降可能在老年糖尿病高危人群糖耐量异常、肥胖、血脂异常和心血管疾病的发生中起着重要的作用。

Study on the Changes and Influence Factors of Plasma Adiponectin Level in Old Abnormal Glucose Tolerance Patients

Objective: To study the changes and influence factors of plasma adiponectin level in old patients with abnormal glucose tolerance. Methods: Weight, waistline, hipline, blood pressure, blood lipid, Oxidation stress imdex and adiponectin were examined in patients older than 60 years old which included normal glucose tolerance (NGT) group, impaired glucose tolerance (IGT) group and type 2 diabetic (DM) group. All patients were divided into high and low adiponectin level groups by the median of adiponectin concentration. Results:Adiponectin level gradually decreased in NGT, IGT and DM groups, which was significantly lower in DM group than those in NGT and IGT groups (P < 0.01). The number of NGT was obviously decreased (7 vs 18) and the number of DM was obviously increased (27 vs 10) compared with low and high adiponectin groups (P < 0.01). Levels of FBS, OGTT 2h increased and HDL decreased (P < 0.01). Logistic Analysis revealed that FBS and HDL were independent risk factors that influenced plasma adiponectin level. Conclusion: The decline of plasma adiponectin level may play an important role in the development of abnormal glucose tolerance, adiposity, abnormal blood lipid and cardiovascular disease in elders.