2型糖尿病患者血清脂联素水平与胰岛素抵抗的关系

【目的】探讨2型糖尿病（T2DM）患者血清脂联素（APN）水平与肥胖、胰岛素及胰岛素抵抗的关系。【方法】采用病例对照研究，T2DM伴有肥胖组（DO）42例，T2DM不伴肥胖组（NDO）42例，正常对照组（NC）28名。检测三组对象血脂、血糖、空腹胰岛素（Fins）、APN水平。用HOMA模型公式计算胰岛素抵抗指数（HOMAIR）。【结果JDO组和NDO组的血清APN水平均明显低于NC组[DO组（8．02±3．57）mg／L，NDO组（8．35±2．68）mg／L比NC组（14．04±4．75）mg／L，均P〈O．01]，DO组与NDO组APN水平差异无显著性。APN与体质指数（BMI）、腰围（w）、腰臀比（WHR）、空腹血糖（FBG）、甘油三脂（TG）、Fins、HO—MAIR呈显著负相关（P〈0．01），APN与高密度脂蛋白（HDL-C）呈显著正相关（P〈0．01）。多元逐步回归分析显示HOMAIR和WHR是血清APN浓度的主要影响因素。【结论】脂联素参与了胰岛素抵抗的发生，与2型糖尿病的发生相关。

Relationship Between Serum Adiponectin and Insulin Resistance in Type 2 Diabetes Mellitus

[Objective] To investigate serum adiponectin concentration in patients of type 2 diabetes mellitus （T2DM） and the relationship between adiponectin and insulin resistance. [Methods] The investigation used a case control study. Serum lipids, fasting glucose, fasting insulin and adiponectin were measured in patients of 42 T2DM with obesity （IX））, 42 T2DM without obesity （NDO） and 28 control subjects （NC）. According to the typical HO- MA model, insulin resistance index （HOMA IR） was calculated. [Results] The result showed that serum adiponectin level was significantly lower in group DO and NDO than that of group NC[DO （8.02±3.57） mg/L, NIX）（＆ 35±2. 68） mg/L vs NC（14.04±4.75） mg/L, both P 〈0.01], while there was not significance difference laetween group DO and group NDO. Correlation analysis showed that serum adiponectin was significantly negatively correlated with body mass index（BMI）, waist circumference（W）, waist-hip ratio（WHR）, fasting glucose（FBG）, serum triglyceride （TG）, fasting insulin（Fins） and HOMA IR （ P -~0.01）, and was positively related with high density lipoprotein- cholesterol（HDL-C） （ P d0.01）. Stepwise regression test showed only HOMA IR and WHR independently affected the level of serum adiponectin. [Conclusion] Serum adiponectin takes part in the development of insulin resistance and is related intimately to the genesis of T2DM.