不同血糖水平人群血清脂联素水平与胰岛素抵抗的关系

目的研究天津地区不同糖耐量人群血清脂联素水平与胰岛素抵抗的关系。方法290例受试者中2型糖尿病患者(DM组)124例、糖耐量减低者(IGT组)66例、正常对照组(NGT组)100例,各组按体重指数(BMI)分成肥胖亚组和非肥胖亚组。测定受试者的身高、体重、腰围、臀围及血浆胆固醇和甘油三酯,并采用放射免疫法测定胰岛素(FINS)、酶联免疫吸附测定(ELISA)法测定血清脂联素水平。结果(1)IGT组和DM组脂联素水平较NGT组明显降低,分别为5.31±1.20mg/L,4.12±0.73mg/L和8.09±0.39mg/L,DM组降低最显著(P<0.05)。(2)与NGT组相比,IGT组的BMI、腰臀比(WHR)、空腹血糖(FBG)、总胆固醇(TC)明显升高,高密度脂蛋白胆固醇(HDL-C)明显下降(P<0.05或P<0.01);DM组的收缩压(SBP)、BMI、WHR、FBG、胰岛素抵抗指数(IRI)、TG的水平均高于前两组,HDL-C明显低于NGT组(P<0.05或P<0.01)。(3)血清脂联素与BMI、WHR、腰围(YW)及体脂含量(FAT%)呈显著负相关,与血胆固醇(TC)水平无相关性,与甘油三酯呈负相关。在本年龄段中,与年龄关系不大。结论(1)脂联素水平在IGT和DM人群中明显降低,提示脂联素在2型DM发病中可能起着一定作用,可以作为2型DM发病的一个预测指标。(2)各组肥胖亚组中IRI明显升高,说明肥胖人群存在IR,而各组肥胖亚组脂联素水平也明显降低,提示肥胖是影响该脂肪因子的重要因素。脂联素可能是联系肥胖、IR和2型DM的一个纽带。

Relationship between Serum Adiponectin Level and Insulin Resistance in People with Different Glucose Levels

Objective To investigate the relationship between serum adiponectin level and insulin resistance in pepole with different glucase tolerance in Tianjin area.Method Insulin was measured with radioimmun-oassay and fasting serum adiponeetin concentration was measured with ELISA assay in 290 cases,including 124 cases of type 2 diabetes(DM group),66 impaired glucose tolerance patients(IGT group),100 controls(NGT group),each group was divided into two subgroups based on body mass index(BMI).Meanwhile BMI,WHR and blood lipid were also measured.Results(1)The serum adiponectin in IGT group and DM group was 5.31±1.20mg/L and 4.12+0.73mg/L,lower than that in NGT group(8.09±0.39mg/L,P<0.01).It declined signficantly in DM group(P<0.05).(2)The levels of BMI,WHR,FBG,TG in IGT group were significantly higher than those in NGT group,while the level of HDLC was greatly decreased(P<0.05 or P<0.01).Compared with IGT and NGT groups,the patients with type 2 diabetes had higher BMI,WHR,SBP,FBG,IRI and TG and lower HDL-C 1evels(P<0.05 or P<0.01).(3)Serum adiponectin concentration was significantly negatively correlated with BMI,WHR and FAT%,was negatively correlated with TG,but was not correlated with TC and age.Conclusions(1)Fasting serum adiponectin concentration in IGT and DM groups is lower than that in NGT group,which indicates that it probably plays a role in the development of type 2 DM and maybe a prognostic index.(2)IRI was markedly higher in obese subgroups,which shows that IR exists in obese subjects.Adiponectin level is significantly lower in obese subgroups,which indicates that obesity was an important influential factor to adiponectin.Adiponectin may be a connective linking of obesity,IR and type 2 DM.