【摘要】 目的探讨血清Chemerin与T2DM合并大血管病变患者体脂参数、糖脂代谢的关系。方法（1）新诊断T2DM患者80例按照有无下肢血管病变分为单纯T2DM组及T2DM合并下肢血管病变组,其中,T2DM合并下肢血管病变组再分为轻度亚组、中度亚组和重度亚组;另选取健康体检者（NGT）20名。ELISA检测各组血清Chemerin浓度、糖脂代谢参数和FIns等指标,稳态模型评估胰岛素抵抗指数（HOMA-IR）,计算BMI和腰身比（WSR）。（2）将研究对象分为WSR≤0.55组和WSR>0.55组,比较两组Chemerin水平。结果 T2DM合并下肢管病变中、重度亚组BMI、WSR、2 hPG、TG、Chemerin水平高于NGT组;重度亚组FPG、2 hPG、HbA₁ c、HOMA-IR、TG高于中度亚组（P<0.05）。WSR>0.55组血清Chemerin水平高于WSR≤0.55组（P<0.05）。（3）血清Chemerin水平与BMI、WSR、FPG、2 hPG、HbA₁c、HOMA-IR和TG呈正相关（r=0.386、0.393、0.298、0.388、0.387、0.391、0.175,P<0.05）;与HDL-C呈负相关（r=-0.386,P<0.05）;Logistic回归分析显示,BMI和下肢血管病变积分是血清Chemerin的独立影响因素（P<0.05）,BMI、WSR、TG和Chemerin是下肢血管病变的独立影响因素（P<0.05）。结论 T2DM患者血清Chemerin水平升高,与IR、体脂分布、糖脂代谢相关,且随着T2DM大血管病变程度的加重,Chemerin水平逐渐升高。更多还原

【Abstract】 Objective To investigate the correlation between serum chemerin level and body fat parameters and glucolipid metabolism in type 2 diabetes with macroangiopathy.Methods Subjects with normal glucose tolerance（NGT） and patients with newly diagnosed T2 DM were recruited and divided into three groups:NGT group,simple T2 DM group,and T2 DM combined with lower extremity macroangiopathy group.T2 DM combined with lower extremity macroangiopathy group were further divided into three subgroups:mild,moderate and severe lower extremity macroangiopathy.Serum chemerin concentration,glucolipid metabolic parameters,and fasting insulin levels were measured by enzyme-linked immunosorbent assays.HOMA-IR,body mass index（BMI）,and waist-to-stature ratio（WSR） were also calculated.Results All the subjects were divided into two groups according to their WSR levels:WSR≤0.55 group and WSR>0.55 group.Serum chemerin level was higher in WSR>0.55 group than in WSR≤0.55 group（P<0.05）.BMI,WSR,2 hPG,TG,and chemerin level were higher in severe lower extremity macroangiopathy subgroup than in NGT group（P<0.05）.FPG,2 hPG,HbA₁ c HOMA-IR,TG were higher in severe lower extremity macroangiopathy subgroup than in moderate lower extremity macroangiopathy subgroup（P < 0.05）.A positive correlation was found between serum chemerin level and BMI,WSR,FPG,2 hPG,HbA₁c,HOMA-IR and TG（r=0.386,0.393,0.298,0.388,0.387,0.391,0.175,P<C0.05）,while a negative correlation was found between serum chemerin level and HDL-C（r=-0.386,P<0.05）.Logisitc regression analysis showed that BMI and integration of lower extremity disease were independent factors for serum chemerin（P<0.05）.BMI,WSR,TG and serum chemerin were independent risk factors for the integral of lower extremity disease（P < 0.05）.Conclusion Serum chemerin level increases in T2 DM patients and is associated with IR,body fat distribution and glucolipid metabolism.Serum chemerin increases with the severity of lower extremity macroangiopathy.更多还原