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目的观察新诊断T2DM患者血清高分子量脂联素(HMW-APN)水平,探讨其与糖脂代谢、IR及胰岛β细胞功能的关系。方法 176例研究对象,根据75g OGTT结果分为新诊断T2DM组88例和NGT组88名,两组再以BMI 25kg/m2为切点分为正常体重(NW)亚组和肥胖(OB)亚组。检测各组HbA1c、血糖、胰岛素、血脂及HMW-APN水平。结果T2DM组血清HMW-APN水平低于NGT组[0.99(0.52~1.56)vs 2.53(1.69~5.44)ng/L](P<0.01)。T2DM组和NGT组的OB亚组HMW-APN水平均低于同组内NW亚组[0.74(0.35~1.39)vs 1.21(0.74~2.08)ng/L;2.11(1.47~4.01)vs 4.49(2.40~6.11)ng/L](P<0.05)。相关性分析提示,HMW-APN与BMI、WC、WHR、SBP、TG、FPG、2hPG、HbA1c、FIns、2hIns、胰岛素抵抗指数(HOMA-IR)、高敏C反应蛋白(hsC-RP)呈负相关(P<0.05或P<0.01),与HDL-C、胰岛β细胞功能指数(HOMA-β)呈正相关(P<0.01)。多元逐步回归分析提示,2hPG、hsC-RP及WHR是血清HMW-APN水平的独立影响因素。结论血清HMWAPN水平在新诊断T2DM患者中降低,其与肥胖、糖脂代谢、IR、胰岛β细胞功能及hsC-RP密切相关,提示血清HMW-APN下降可能参与了肥胖和T2DM的发生发展。
Objective To observe the serum level of HMW-APN in newly diagnosed T2DM patients and explore its relationship with glucose and lipid metabolism, IR and pancreatic β-cell function. Methods One hundred and sixty-six subjects were divided into two groups according to 75 g OGTT results: 88 newly diagnosed T2DM patients and 88 NGT patients. The two groups were divided into normal weight (NW) subgroup and obese group. The levels of HbA1c, blood glucose, insulin, blood lipid and HMW-APN in each group were detected. Results The level of serum HMW-APN in T2DM group was significantly lower than that in NGT group [0.99 (0.52-1.56) vs 2.53 (1.69-5.44) ng / L] (P <0.01). The levels of HMW-APN in the OB subgroup of T2DM group and NGT group were significantly lower than those in the NW subgroup (0.74 (0.35-1.39) vs 1.21 (0.74-2.08) ng / L, 2.11 (1.47-4.01) vs 4.49 ~ 6.11) ng / L] (P <0.05). Correlation analysis showed that HMW-APN was negatively correlated with BMI, WC, WHR, SBP, TG, FPG, 2hPG, HbA1c, FIns, 2hIns, HOMA-IR and hsC-RP (P <0.05 or P <0.01), and was positively correlated with HDL-C and HOMA-β (P <0.01). Multivariate stepwise regression analysis showed that 2hPG, hsC-RP and WHR were independent influencing factors of serum HMW-APN level. Conclusions Serum HMWAPN level is decreased in newly diagnosed T2DM patients. It is closely related to obesity, glucose and lipid metabolism, IR, pancreatic β-cell function and hsC-RP, suggesting that the decline of serum HMW-APN may be involved in the development of obesity and T2DM.