【摘要】 目的 检测正常人和胰岛素抵抗综合征患者血清脂联素,进一步探讨脂联素与胰岛素敏感性、血糖、血胰岛素、血脂等的相关性。方法 用减少样本数的Bergman微小模型技术结合静脉葡萄糖耐量试验检测正常、肥胖、糖耐量低减(IGT)和2型糖尿病(DM)患者的胰岛素敏感性指数(SI),同时测定受试者的体重指数(BMI)和腰臀比(WHR),检测空腹状态下脂联素和血脂、空腹和餐后2h血糖及胰岛素水平。结果 与正常组相比,肥胖、IGT和2型DM组的SI均显著降低,差异有显著性(P<0.001),而非正常组之间此指标差异无显著性。正常组的血清脂联素[(12.84±3.64)mg/L]显著大于肥胖、IGT和2型DM组[(7.65±2.45、7.55±2.64、5.19±2.36)mg/L,均P<0.001],后3组中2型DM组的脂联素显著低于肥胖和IGT组,差异有显著性(P<0.01,P<0.05),而肥胖组和IGT组间此值差异无显著性。脂联素与SI呈正相关,而与腰围、BMI、WHR和空腹、餐后2h血糖及血甘油三酯呈显著负相关。多元逐步回归分析提示血清脂联素与SI(r~2=0.29)、空腹血糖(r~2=0.26)、WHR(r~2=0.17)具有高度的相关性(均P<0.05)。结论 胰岛素抵抗综合征患者血清脂联素水平显著降低,并以2型DM患者降低更为明显;血清脂联素与SI呈正相关,而与空腹血糖和WHR呈显著负相关。更多还原

【Abstract】 Objective To assay the serum adiponectin levels in normal subjects and patients with insulin resistance syndrome, and to explore the correlation between adiponectin and insulin sensitivity, blood glucose, insulin, lipids etc. Methods Insulin sensitivity index (SI) was assessed by the reduced sample number of Bergman’s minimal model method with intravenous glucose tolerance test in subjects of normal controls, obesity, impaired glucose tolerance (ICT) and type 2 diabetes mellitus (DM). Meanwhile the anthropometrical parameters such as body mass index (BMI) and waist hip ratio (WHR) were evaluated and the serum lipids, fasting and postprandial 2 h plasma glucose and insulin levels were also measured. Results Compared with normal control group, the SI in obesity, IGT and type 2 DM groups was significantly decreased (P<0.001),and there was no difference between those abnormal groups. Serum adiponectin level in normal control group [(12.84±3. 64)mg/L] was significantly higher than those of obese, IGT and type 2 DM groups [(7.65±2.45, 7.55±2.64, 5.19±2.36) mg/L, all P<0.001],and adiponectin level in type 2 DM was significantly lower than those of obese and IGT groups (P<0.01, P <0.05),but there was no significant difference between obese group and IGT group.Serum adiponectin level was positively correlated with SI and negatively correlated with waist circumference, BMI, WHR, fasting plasma glucose, postprandial 2 h plasma glucose and serum triglyceride level. In a general multivariate regression, the SI (r=0.29),fasting blood glucose (FBG,r2= 0.26),and WHR (r2=0.17) were significantly independent determinants for serum adiponectin concentration (all P<0.05). Conclusion In patients with insulin resistance syndrome, the serum adiponectin level is significantly decreased, especially in type 2 DM patients, and adiponectin is positively correlated to SI but negatively correlated with WHR and FBG.更多还原