2型糖尿病患者血清内脂素、游离脂肪酸与胰岛素抵抗的相关性研究

目的 探讨2型糖尿病（T2DM）患者血清内脂素、游离脂肪酸（FFA）与胰岛素抵抗的相关性.方法 对119例T2DM患者和65例正常糖耐量对照者（NGT）,均测定血清内脂素、FFA和相关的临床指标,计算胰岛素抵抗指数（HOMA-IR）和腰臀比,并对影响因素行相关分析.结果 T2DM患者血清内脂素、FFA水平高于NGT者（4.7±2.5）与（1.7±0.9）ng/L,t=-11.831,P＜0.01;（1.65±0.69）与（0.61±0.21） mmol/L,t=-9.239,P＜0.01];T2DM伴胰岛素抵抗者（61例）血清内脂素、FFA水平明显高于T2DM不伴胰岛素抵抗者（58例）、正常对照者（6.3±2.3）与（3.0±1.4）、（1.7±0.8）ng/L,F=133.306,P＜0.01;（2.16±0.45）与（1.12±0.46）、（0.61±0.21）mmol/L,F=260.169,P＜0.01].多元线性逐步回归分析显示FFA、空腹胰岛素、腰臀比是内脂素的独立相关因素（r值分别为0.564、0.267和0.188,均P＜0.05）.结论 T2DM患者内脂素和FFA水平显著升高,且与胰岛素抵抗关系密切.

Correlation of serum visfatin and free fatty acid with insulin resistance in type 2 diabetes

Objective To investigate the association of serum visfatin and free fatty acid （FFA） with insulin resistance in type 2 diabetes mellitus （T2DM）.Methods One hundred and nineteen patients with T2DM and 65 health subjects with normal glucose tolerance （NGT） were enrolled in the study.TheT2DM patients were further classified as insulin resistant （HOMA-IR 〉 2.8 mU/L,T2DM-IR group,n =61） and non-insulin resistant （HOMA-IR≤2.8 mU/L,T2DM-NIR group,n =58）.Serum visfatin,free fatty acid and related clinical variables were measured,and HOMA-IR was calculated.Results The serum levels of visfatin and FFA in T2DM patients were significantly higher than those in healthy controls （4.7 ±2.5） vs.（1.7±0.9） ng/L,t=-11.831,P〈0.01; （1.65±0.69） vs.（0.61 ±0.21） mmol/L,t=-9.239,P 〈0.01].The serum levels of visfatin and FFA in T2DM-IR group were significantly higher than those in T2DM-NIR group （6.3±2.3） vs.（3.0±1.4） ng/L,P〈0.01; （2.16±0.45） vs.（1.12± 0.46） mmol/L,P 〈0.01].Multiple regression analysis showed that FFA,fasting insulin level and waist/ hip ratio （WHR） were independent risk factors of serum visfatin level （r =0.564,0.267 and 0.188 respectively,all P 〈 0.05）.Conclusion Serum levels of visfatin and FFA are increased in T2DM,and they are closely associated with insulin resistance.