2型糖尿病及酮症患者血浆丝氨酸蛋白酶抵制剂水平变化及相关因素分析

目的 探讨初诊2型糖尿病(T2DM)及酮症(T2DK)患者血浆丝氨酸蛋白酶抵制剂(Vaspin)水平变化与BMI、血脂、血糖、胰岛素抵抗指数(HOMA-IR)等的关系.方法 采用ELISA法测定28例T2DM患者、32例T2DK患者及25例正常人(NC组)血浆Vaspin水平,分析血浆Vaspin水平与BMI、血脂、血糖和HOMA-IR等的关系.结果 T2DM组血浆Vaspin水平明显高于NC组(0.71±0.18 )μg/L vs (0.52±0.13 )μg/L,P＜0.05],T2DK组又明显高于T2DM组(1.95±0.21)μg/L vs (0.71±0.18)μg/L,P＜0.01].空腹血浆Vaspin水平分别与BMI、三酰甘油(TG)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)和HOMA-IR呈明显正相关(P＜0.05),与Fins和胰岛素分泌指数(HOMA-IS)呈明显负相关(P＜0.05).BMI、FPG和HOMA-IR是影响血浆Vaspin水平的独立相关因素.结论 血浆Vaspin水平的改变与糖脂代谢紊乱和胰岛素抵抗有关,并可能参与了T2DM及T2DK的发生和发展.

Change of Serum Vaspin Level and Re1ated Factor in Patients with Type 2 Diabetes Mellitus and Its Ketosis

Objective To investigate the changes of plasma visceral adipose tissue-derived serine protease inhibitor(Vaspin)levels and the relationship of plasma Vaspin levels with body mass index(BMI),blood glucose and lipids,HOMA-insulin resistance index(HOMA-IR)and other factors in patients with type 2 diabetes mellitus(T2DM)and its ketosis(T2DK).Methods Plasma Vaspin levels were measured by ELISA in 28 patients with newly diagnosed T2DM,32 subjects with T2DK and 25 control subjects.The relationship of plasma Vaspin level with BMI,blood glucose and lipids and HOMA-IR were also analyzed.Results Plasma Vaspin levels were significantly increased in T2DM than in control((0.71±0.18)μg/L vs(0.52±0.13)μg/L,P<0.05),and higher in T2DK than in T2DM((1.95±0.21)μg/L vs(0.71±0.18)μg/L,P<0.01).Plasma Vaspin levels correlated positively with BMI,triglyceride(TG),FBG,glycosylated hemoglobin(HbA1c)and HOMA-IR(P<0.05),and negatively with Fins and HOMA-Islet β cell Secretion index(HOMA-IS)(P<0.05).BMI,FBG and HOMA-IR were independently related factor influencing plasma Vaspin levels.Conclusion Plasma Vaspin levels associate with metabolism disorder and insulin resistance,and it may contribute in part to the pathogenesis of T2DM and T2DK.