2型糖尿病患者血脂水平与血清Apelin等细胞因子的关系研究

目的了解2型糖尿病患者不同的血脂水平与血清、Apelin、脂联素、抵抗素等脂肪细胞因子的关系。方法所有的门诊或病房的2型糖尿病患者均空腹12h以上,取肘静脉血,分离血清,当日送检血脂及空腹血糖、胰岛素,其余血清置-80℃冰箱保存以备测定血清Apelin,脂联素及抵抗素。记录入选对象的年龄、糖尿病病程、身高、体重,通过公式计算BMI（体质指数）=体重/身高2（kg/m^2）,FPG（空腹血糖）及FINS（空腹胰岛素）并计算胰岛素抵抗指数（HOMA-IR）=（FPG×FINS/22.5）。然后根据化验结果将患者分为2组。伴有高脂血症组,与血脂正常组。其中高脂血症组再分为：高甘油三酯组,高胆固醇组及混合组（2个指标均高于正常）,然后进行血脂与各组脂肪因子以及胰岛素抵抗指数的相关分析。结果两组患者,不同血脂水平之间的脂肪细胞因子差异有统计学意义。糖尿病患者血清Apelin水平与TG（甘油三酯）、FFA（游离脂肪酸）、BMI、FINS呈显著正相关（分别r=0.766;r=0.675;r=0.780;r=0.821）,P值均〈0.05,而与TC（胆固醇）、HDL-C（高密度脂蛋白）、LDL-C（低密度脂蛋白）无相关性。结论2型糖尿病患者中伴有脂代谢紊乱者，血清Apelin水平明显升高且与患者的甘油三酯，游离脂肪酸的浓度密切相关，呈明显正相关。升高的Apelin水平可能参与与胰岛素抵抗的发生，其具体机制尚不明确，需进一步研究。

Relationship between serum apelin,adiponectin, resistin and blood lipid level in patients with type 2 diabetes

Objective To investigate the relationship between serum apelin, adiponectm, resistm and blood lipid level in patients with type 2 diabetes. Methods Seventy-nine patients with type 2 diabetes were recruited and divided into 4 groups according to the lipid levels： A： normal lipid metabolism group, B： hypertriglycridemia group; C： hypercholesterolemic group, D： B and C group. The serum apelin levels was determined with competitive ELISA, the apelin levels of 4 groups were compared. The body mass index （BMI）, fasting plasma glucose （FPG）, fasting insulin levels were also measured. Results The serum apelin level in type 2 diabetes with hypertriglycridemia was significantly higher than normal lipid metabolism group. Correlation analysis showed that the serum apelin level in type 2 diabetes was positively correlated with TG （ r = 0.766 ）, FFA （ r = 0.675 ）, BMI （ r = 0. 780 ）, FINS （ r = 0.821 ）. Conclusion Serum apelin levels in type 2 diabetes patients with lipid metabolism disorder increased. Apelin is correlated with TG, FFA, BMI and FINS.