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目的通过检测1型糖尿病(T1DM)患儿及T1DM合并酮症酸中毒患儿血清内脂素(visfatin)水平,探讨血清visfatin与T1DM及酮症酸中毒患儿的糖脂代谢及胰岛β细胞功能的相关性。方法选取2010年6月-2014年6月于广元市中心医院门诊就诊和住院的1型糖尿病患儿82例,正常对照组31例,1型糖尿病患儿分为初诊T1DM组(T1DM I组)61例,T1DM合并酮症酸中毒组(T1DMⅡ组)21例。比较三组血清visfatin水平、空腹血糖(FPG)、空腹胰岛素(Fins)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、游离脂肪酸(FFA)及糖化血红蛋白(HbAlc),体质指数(BMI)及腰臀比(WHR)。并进行T1DM I组和T1DMⅡ组的血清visfatin与其他监测指标的单因素相关性分析,及血清visfatin与其相关因素的多元线性逐步回归分析。结果 1)儿童T1DM I组血清visfatin水平明显低于正常对照组(P<0.01),T1DMⅡ组血清visfatin水平较T1DM I组明显降低(P<0.01)。2)采用Pearson相关分析,在T1DM I组和T1DMⅡ组中血清visfatin均与BMI、WHR、HDL-C、Fins、Homa-β呈正相关,均与TC、TG、LDL-C、FFA、FPG、HbAlc呈负相关。多元线性逐步回归分析显示,T1DM I组和T1DMⅡ组的WHR、FFA、FPG、Homa-β进入回归方程,WHR、FFA、FPG、Homa-β是影响血清visfatin水平的独立危险因素。结论 1型糖尿病及合并酮症酸中毒患儿血清visfatin水平较正常组明显降低,可能与内脏脂肪含量减少,糖脂代谢紊乱及胰岛β细胞功能损害有关。
Objective To investigate the serum visfatin levels in children with type 1 diabetes mellitus (T1DM) and T1DM combined with ketoacidosis and to explore the relationship between serum visfatin and T1DM and ketoacidosis in children with diabetes mellitus and pancreatic β-cell function Relevance. Methods Totally 82 children with type 1 diabetes treated in outpatient department and hospitalized in Guangyuan Central Hospital from June 2010 to June 2014 were enrolled in this study. Totally 31 cases of normal control group and 1 case of type 1 diabetes were divided into two groups: newly diagnosed T1DM group (T1DM group) 61 cases, T1DM combined ketoacidosis group (T1DM Ⅱ group) 21 cases. The levels of serum visfatin, fasting blood glucose (FPG), fasting insulin (Fins), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol -C), free fatty acids (FFA) and HbAlc, body mass index (BMI) and WHR. Single factor correlation analysis between serum visfatin and other monitoring indexes in T1DM group and T1DM Ⅱ group and multivariate linear stepwise regression analysis of serum visfatin and related factors were performed. Results 1) The level of serum visfatin in T1DM group was significantly lower than that in normal control group (P <0.01). The level of visfatin in T1DM group was significantly lower than that in T1DM group (P <0.01). 2) Pearson correlation analysis showed that serum visfatin was positively correlated with BMI, WHR, HDL-C, Fins and Homa-β in T1DM group and T1DMⅡgroup, all of which were correlated with TC, TG, LDL-C, FFA, FPG, HbAlc Negative correlation. Multivariate linear stepwise regression analysis showed that WHR, FFA, FPG and Homa-β in T1DM group and T1DMⅡgroup were in regression equation. WHR, FFA, FPG and Homa-β were independent risk factors of serum visfatin. Conclusions Serum visfatin levels in children with type 1 diabetes and ketoacidosis were significantly lower than those in normal controls, which may be related to the reduction of visceral fat content, the disturbance of glucose and lipid metabolism, and the impairment of pancreatic β-cell function.